Author: Wilson R, Baines S, Cornford J, Martin M
Journal: International Journal of Integrated Care, 2007
Volume/pages: Vol 7(2), available from the International Journal of Integrated Care

About the study
This study explores the goal of integration in the context of the implementation of the Single Assessment Process (SAP) for older people and the consideration of two contrasting SAP programmes (one led by social services, the other by an NHS Trust) and their diverse outcomes. It gives historical and policy context to the introduction of the SAP and focuses specifically on the introduction of ICT in enabling information sharing with the intention of providing more integrated care for older people.

Findings
The study found that a ‘joined-up’ or ‘whole systems’ approach to integration, particularly in the context of ICT-based information sharing, appears to offer the best chance of improving service integration. However, the challenge then becomes the ‘joining up’ of the procurement and design of an information system that supports service delivery.

Key messages

• There is a tension between the demands of a ‘whole system’ approach, which can lead to the expansion of the scope of integration, and those of an ‘open systems’ approach, which accepts that the boundary of the ‘whole system’ is always fluid and ambiguous.
• The ability to continuously make sense of how the elements of the care systems can and should fit together is key to improving the experience of individual older people.