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Is integration or fragmentation the starting point to improve prevention?

HSMC's policy paper 17 is based on a discussion paper which was commissioned by the Institute for Social Change at Manchester University as part of a series of Knowledge Exchange Trials workshops which brought together academics, policy makers and programme stakeholders to facilitate exchange of ideas, expertise and research.

University of Birmingham Aston Webb building

This policy paper is based on a discussion paper which was commissioned by the Institute for Social Change at Manchester University as part of a series of Knowledge Exchange Trials workshops which brought together academics, policy makers and programme stakeholders to facilitate exchange of ideas, expertise and research.

The importance of health, social care and other sectors working together has been recognised for many decades by governments of all political persuasion. This is true within the current policy environment, in which integration has been proposed as the binding force to connect an increasingly diverse range of providers around individual patients and their families. Initiatives to promote integration are being introduced at all levels of the system, with a patient experience based narrative setting the standard against which success should be judged. This integration is being encouraged not only in respect of statutorily funded clinical, public health and social care services but also with other policy areas such as housing and leisure and other sectors (in particular the third sector).

Despite this continued belief in policy that integration will lead to a more preventative focus there is not a strong research base to support this view; however, accepting the limitations of the evidence base, this Policy Paper looks at five key lessons which can still be drawn for national policy makers with responsibility for promoting integration and prevention.