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Tucker, Helen Jean
Languages: English
Types: Doctoral thesis
Subjects: RA0421, R1
Background: Integrated care is a policy imperative in health and social care services\ud globally, and yet there are reported difficulties in defining, developing and sustaining\ud this way of working.\ud Research Question: This research explores staff views and experiences of the presence,\ud nature and development of integrated care in two programmes of community services.\ud Method: A case study approach was adopted using secondary analysis of qualitative data\ud from staff questionnaires using themed content analysis and pattern matching, with\ud findings triangulated with documentary sources. The study considers the presence and\ud nature of integrated care using the conceptual framework “to what extent integrated care\ud is for everyone (inclusive) and not just for some (exclusive)” as interpreted from the\ud literature. The development of integrated care was explored using systems theory for the\ud management of change in a complex environment.\ud Findings: A meta-analysis of the two case studies demonstrated that integration was\ud present in all 66 services within the two programmes. The nature of integrated care\ud varied and was demonstrated as multiple types (in community hospitals) and processes\ud (in community services). The most frequently reported type was multidisciplinary\ud working. The processes most teams chose to develop were information sharing systems.\ud The development of integration within the case studies was affected by a number of\ud factors, such as commitment and staffing.\ud Conclusion: This study provides new evidence of the presence, nature and development\ud of integration within a wide range of established services spanning all ages. From this\ud and other measures, the extent to which integrated care is presented as “exclusive” can\ud be questioned. These findings have informed the development of a framework of five\ud principles, reflecting whether integrated care is: for everyone, extensive, enduring, can\ud be enabled and essential. The implications and application of this research for policy,\ud service development and training are discussed, and proposals for further research\ud include testing the applicability of this framework and widening this study.
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