The Evidence Base for Integrated Care

It has become commonplace to highlight that, despite the vigorous promotion of integrated working, both in health care and between health and social care, the evidence base, particularly in terms of outcomes for the presumed beneficiaries, is fragmentary. A number of oft-quoted reviews have explored the detail (Cameron et al, 2000; El Ansari et al, 2001; Dowling et al, 2004; Ramsay & Fulop, 2008). Perhaps surprisingly, however, there has been no readily accessible and regular update of the evidence base. This is now being rectified by an initiative at research in practice for adults, with support from the Integrated Care Network. The idea of establishing an evidence base, updated regularly, grew out of an ESRC research seminar series titled Partnership Working Between Health and Social Care: Building Capacity for Change held between 2005 and 2007. The systematic review by Cameron and colleagues (2000) identified four models for joint working: placement schemes, multi-agency teams and projects, case or care management, and strategic-level working. The team identified 32 studies from 38 papers which grouped drivers and barriers for joint working into three themes: organisational issues, cultural and professional issues, and contextual issues. The review concluded that there was a: