Author: Johnson P, Wistow G, Schulz R, Hardy B
Journal: Journal of Interprofessional Care, 2003
Volume/pages: Vol 17(1), pp69-83

About the study
This paper explore the problems of integrated working in community care. It draws on theoretical and empirical literature from both the US and the UK supplemented and supported by local case studies representing both rural and urban settings to build a framework to critically review the NHS Plan 2000. It explores the barriers to integration against a backdrop of pooled budgets and Health Act 1999 partnership flexibilities.

Findings
The authors found that differences in political views and goals, fear of budgetary repercussions, differences in medical and social work cultures and competing demands on staff all worked against the development of trust and stable working relationships necessary for successful integration or collaboration. Integration was easier where agencies shared clear values and goals, well-accepted protocols for best practice and a relatively small and steady population with fairly well defined needs such as in services for people with learning disabilities.

Key messages

• Conflicts between the values and interests of different agencies and professions can undermine attempts at structural integration.
• To be successful, integration needs to happen at the team level as well as at structural or organisational level.