Reframing the evaluation of integrated care; examples from the NHS in England
Bibliographic Data
| ID | 21467118 |
|---|---|
| Authors | Tom Ling (0000-0002-0185-6834, RAND Europe, corresponding author), Nick Fahy (0000-0003-4957-0189, RAND Europe), Jessica Dawney (0009-0001-8622-7227, RAND Europe) |
| Year | 2025 |
| Volume | 160 |
| Pages | 105418 |
| Publication date | 2025-10-01 |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Health Policy (JOURNAL) |
| Journal identifiers | ISSN: 0168-8510 • E-ISSN: 1872-6054 |
| Publisher | Elsevier BV (PUBLISHER) |
| DOI | 10.1016/j.healthpol.2025.105418 |
| PMID | 40897593 |
| OpenAlex | W4413385008 |
| Language | EN |
| References cited | 22 |
There is global interest in integrated care, often associated with how to improve system efficiency, strengthen clinical and cost-effectiveness, avoid gaps in patient care, and improve patient experiences and outcomes, through improved coordination across services. Despite considerable activity in both delivering and evaluating integrated care, evaluations have not greatly helped to understand how to 'do' it better. Evaluations of integrated care have often arrived at similar conclusions, frequently including the generic finding that results are patchy and context dependent. In this article, we explore and discuss these challenges to evaluation, how these challenges are understood in recent key publications, and suggest an alternative perspective. We explore technical inadequacies of evaluations (concerning definitions, metrics, and timing) as well as deeper problems (such as integrated care being dynamic and relational, and operating across multiple, larger systems). In re-framing how to evaluate integrated care, we propose an approach that involves a recursive evaluation architecture. This draws on systems thinking. This approach also recognises that we can better understand evaluations of integrated care as co-producing knowledge and applying this to learning and adaptation
Cognitive reframing · New england · Political science · Health Policy Implementation Science · Interprofessional Education and Collaboration · Law · Medicine · Nursing · Primary Care and Health Outcomes · Psychology · Public Administration · Social Psychology
The effects of integrated care
The impacts of collaboration between local health care and non-health care organizations and factors shaping how they work
A new framework for developing and evaluating complex interventions
Developing and evaluating complex interventions
Implementing integrated care infrastructure
The Long-Term Impacts of an Integrated Care Programme on Hospital Utilisation among Older Adults in the South of England
Integrated Care in England – what can we Learn from a Decade of National Pilot Programmes
Understanding Integrated Care
The Interface between Evaluation and Public Policy
When and how do ‘effective’ interventions need to be adapted and/or re-evaluated in new contexts? The need for guidance
Theorising Interventions as Events in Systems
When Tensions Become Opportunities
| Highly cited | No |
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