Challenges and chances for local health and social care integration – Lessons from Greater Manchester, England

IF 0.8 Q4 HEALTH POLICY & SERVICES
Ming Chang
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Abstract

PurposeSustainability and transformation partnerships (STPs) were introduced to England, asking 44 local areas to submit their health and social care plans for the period from October 2016 to March 2021. This study aims to offer a deeper understanding of the complex structure in the local practice, and to discuss the associated challenges and chances.Design/methodology/approachDocumentary analysis, qualitative interviews and questionnaire survey are used for this study. Findings have been compared and analysed thematically.FindingsThe study participants reported that apart from pooled budgets, past collaborative experience and local leadership are crucial elements for transforming health and social care integration in Greater Manchester (GM). Also, this study provides policy recommendations to promote effective collaborative partnerships in local practices and mitigate local inequity of funding progress.Research limitations/implicationsThe findings of this paper cannot be extrapolated to all stakeholders due to the limited samples. Meanwhile, some of the discussions about the case of GM may not be transferrable to other STPs.Originality/valueThis study argues that the success of pooled budgets is the result, rather than the cause, of effective negotiations between various stakeholders; and therefore, there is no evidence suggesting that pooled budgets can resolve the discoordination of health and social care. Moreover, due to the bottom-up approach adopted by STPs, more effective boroughs tend to receive additional funding, resulting in an increasing gap of development between effective and ineffective boroughs.
地方卫生和社会保健一体化的挑战和机遇——来自英格兰大曼彻斯特的经验教训
可持续性和转型伙伴关系(stp)被引入英格兰,要求44个地方地区提交2016年10月至2021年3月期间的健康和社会保健计划。本研究旨在对当地实践中的复杂结构提供更深入的理解,并讨论相关的挑战和机遇。设计/方法/方法本研究采用文献分析、定性访谈和问卷调查。对研究结果进行了主题比较和分析。研究参与者报告说,除了集中预算外,过去的合作经验和地方领导是大曼彻斯特(GM)转变卫生和社会保健整合的关键因素。此外,本研究还提供了政策建议,以促进地方实践中的有效合作伙伴关系,并减轻地方资助进展的不平等。研究的局限性/意义由于样本有限,本文的研究结果不能外推到所有利益相关者。与此同时,关于通用汽车案例的一些讨论可能无法转移到其他stp。独创性/价值本研究认为,集合预算的成功是各利益相关者之间有效谈判的结果,而不是原因;因此,没有证据表明,集中预算可以解决卫生和社会保健的不协调。此外,由于stp采用自下而上的方式,更有效的行政区往往会获得额外的资金,导致有效和无效的行政区之间的发展差距越来越大。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Integrated Care
Journal of Integrated Care HEALTH POLICY & SERVICES-
CiteScore
1.70
自引率
12.50%
发文量
34
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