Problems with Integrated Health and Social Care: Why integration doesn't solve the problem of fragmentation in public services.
Rob's heresy covered one of the major assumptions in public policy, that integration solves the problem of fragmentation in public services.
Integrating Health and Social care has been a policy mantra for governments since the late 90's. The programme for integration is rooted in a series of responses to a panoply of high profile service disasters Alder Hey, Shipman, Climbie, combined with ongoing service governance and delivery issues like 'interprofessional collaboration', 'common assessments' 'bed blocking' and 'performance management'.
Rob's work showed that despite the high level of political rhetoric and resources expended on 'integration' there is little evidence that it works beyond place based pilots. His research indicates that significant questions remain about ‘what have we learned’ about if, how and when integration works.
This heresy examined integration as an idea and contrast it with the wider fragmentation, questioning whether integration efforts might be better focussed on joining-up the joining-up.