Integrated care

Providing better integrated care is a priority, especially as the population ages with an increasing number of complex multi-morbid patients. Our evaluation of the Department of Health Integrated Care Pilots identified the barriers and facilitators to providing better integrated care. A lot depended on developing effective local relationships and small schemes with a clear focus were much easier to get off the ground than more ambitious ones. Our evaluation failed to show the intended reduction in emergency admissions resulting from intensive case management of frail elderly people. Indeed, emergency admissions rose, and not all patient experience reports were positive. The evaluation shows the many challenges of providing better integrated care to a complex elderly population. More recently, we have started an evaluation of an ambitious borough-wide project to provide better integrated care in South London.