How do policy supports enable the implementation, scale, and sustainability of integrated care programs in England, Germany, and The Netherlands? Lessons for Canada.

Background: Integrated care aims to coordinate the care needs of a population, particularly individuals requiring complex care, across community, primary and secondary care settings. This study explores policy supports for integrated models of care in England, Germany, and The Netherlands to consider the implications for policy transfer for Canada.

Methods: We reviewed academic and grey literature about integrated models of care across three comparator countries and conducted in-depth qualitative interviews with 14 expert informants in Autumn 2023. Results were mapped against a framework for analysis about policy supports and transfer.

Results: Integrated care initiatives varied in scale and scope with local population initiatives (Germany), devolved decision-making initiatives (England), or by addressing population subgroups (Netherlands). There are power and relative funding imbalances between the health and social services sectors that impede collaboration. Voluntary approaches to organisational governance reforms and partnerships with primary care providers promote uptake but policy entrepreneurs are crucial to facilitating implementation. Workforce adaptations and upskilling initiatives can enable interprofessional collaboration and intersectoral knowledge to address implementation gaps. There remain practical challenges with data infrastructure and sharing.

Conclusions: Legislation is an important enabling factor for supporting governance. New financing streams can reward collaborative working for interdisciplinary teams. Policymakers at the macro- and meso‑level must support policy from intention to implementation.