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Challenges in integrating health and social care : the Better Care Fund in England
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Harlock, Jenny, Caiels, James, Marczak, Joanna, Peters, Michele, Fitzpatrick, Raymond, Wistow, Gerald, Forder, Julien and Jones, Karen (2020) Challenges in integrating health and social care : the Better Care Fund in England. Journal of Health Services Research & Policy, 25 (2). pp. 86-93. doi:10.1177/1355819619869745 ISSN 1355-8196.
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Official URL: https://doi.org/10.1177/1355819619869745
Abstract
Objectives
The Better Care Fund is the first and only national policy in England that has legally mandated the use of pooled budgets to support local health and social care systems to provide better integrated care.
Methods
We report qualitative findings from the first national multi-method evaluation of the Better Care Fund, focusing on its implementation, perceptions of progress and expected impacts among key stakeholders. Interviews were carried out with 40 staff responsible for Better Care Fund implementation in 16 local health and social care sites between 2017 and 2018.
Results
Study participants reported their experiences of implementation, and we present these in relation to three themes: organizational issues, relational issues and wider contextual issues. Participants stressed the practical and political challenges of managing pooled budgets and the complexity of working across geographical boundaries. In a context of unprecedented austerity, shared vision and strong leadership were even more vital to achieve collaborative outcomes.
Conclusion
Pooling budgets through the Better Care Fund can lever closer collaboration between sectors and services. Shared vision and leadership are essential to develop and foster this closer collaboration. Although some successes were reported, the study highlights that there are major cultural, operational and territorial barriers to overcome.
Item Type: | Journal Article | ||||||||
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Subjects: | H Social Sciences > HV Social pathology. Social and public welfare R Medicine > RA Public aspects of medicine |
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Social Science & Systems in Health (SSSH) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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SWORD Depositor: | Library Publications Router | ||||||||
Library of Congress Subject Headings (LCSH): | Medical care, Medical care -- England, Medical care -- Government policy -- England, Integrated delivery of health care , Integrated delivery of health care -- England, Medical care, Cost of , Medical care, Cost of -- England, Social service, Social service -- England | ||||||||
Journal or Publication Title: | Journal of Health Services Research & Policy | ||||||||
Publisher: | Royal Society of Medicine Press Ltd. | ||||||||
ISSN: | 1355-8196 | ||||||||
Official Date: | 1 April 2020 | ||||||||
Dates: |
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Volume: | 25 | ||||||||
Number: | 2 | ||||||||
Page Range: | pp. 86-93 | ||||||||
DOI: | 10.1177/1355819619869745 | ||||||||
Status: | Peer Reviewed | ||||||||
Publication Status: | Published | ||||||||
Reuse Statement (publisher, data, author rights): | Posted ahead of print. Harlock, Jenny, Caiels, James, Marczak, Joanna, Peters, Michele, Fitzpatrick, Raymond, Wistow, Gerald, Forder, Julien and Jones, Karen (2019) Challenges in integrating health and social care : the Better Care Fund in England. Journal of Health Services Research & Policy . doi:10.1177/1355819619869745 (In Press) Copyright © 2019 The Authors. Reprinted by permission of SAGE Publications. DOI: [DOI] | ||||||||
Access rights to Published version: | Restricted or Subscription Access | ||||||||
Date of first compliant deposit: | 27 September 2019 | ||||||||
Date of first compliant Open Access: | 27 September 2019 | ||||||||
RIOXX Funder/Project Grant: |
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