Tucker, Helen Jean (2012) Integrated care : the presence, nature and development of integrated care in community health services in England and Ireland. PhD thesis, University of Warwick.

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Abstract

Background: Integrated care is a policy imperative in health and social care services
globally, and yet there are reported difficulties in defining, developing and sustaining
this way of working.
Research Question: This research explores staff views and experiences of the presence,
nature and development of integrated care in two programmes of community services.
Method: A case study approach was adopted using secondary analysis of qualitative data
from staff questionnaires using themed content analysis and pattern matching, with
findings triangulated with documentary sources. The study considers the presence and
nature of integrated care using the conceptual framework “to what extent integrated care
is for everyone (inclusive) and not just for some (exclusive)” as interpreted from the
literature. The development of integrated care was explored using systems theory for the
management of change in a complex environment.
Findings: A meta-analysis of the two case studies demonstrated that integration was
present in all 66 services within the two programmes. The nature of integrated care
varied and was demonstrated as multiple types (in community hospitals) and processes
(in community services). The most frequently reported type was multidisciplinary
working. The processes most teams chose to develop were information sharing systems.
The development of integration within the case studies was affected by a number of
factors, such as commitment and staffing.
Conclusion: This study provides new evidence of the presence, nature and development
of integration within a wide range of established services spanning all ages. From this
and other measures, the extent to which integrated care is presented as “exclusive” can
be questioned. These findings have informed the development of a framework of five
principles, reflecting whether integrated care is: for everyone, extensive, enduring, can
be enabled and essential. The implications and application of this research for policy,
service development and training are discussed, and proposals for further research
include testing the applicability of this framework and widening this study.

Item Type:	Thesis or Dissertation (PhD)
Subjects:	R Medicine > R Medicine (General) R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Library of Congress Subject Headings (LCSH):	Integrated delivery of health care -- England, Integrated delivery of health care -- Ireland, Community health services -- England, Community health services -- Ireland, Meta-analysis, Community health services -- Case studies, Integrated delivery of health care -- Case studies
Official Date:	July 2012
Dates:	Date Event July 2012 Submitted
Institution:	University of Warwick
Theses Department:	Warwick Medical School
Thesis Type:	PhD
Publication Status:	Unpublished
Supervisor(s)/Advisor:	Griffiths, Frances; Meads, Geoff
Extent:	429 leaves : charts.
Language:	eng

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