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Title: Joined-up or joining-up the joining-up? : integration and overintegration in health and social care
Author: Wilson, Robert George
Awarding Body: University of Newcastle Upon Tyne
Current Institution: University of Newcastle upon Tyne
Date of Award: 2012
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Integration of health and social care services and systems was a driving policy objective of the UK government for over a decade, aiming to improve co-ordination of care and service delivery. One of the theories behind the integration of policy and practice was that it could be achieved through the implementation of information systems tools or technologies. This doctoral statement examines integration as a solution to these challenges of Joining-up' through the lens of a coherent set of published works telling the story through three projects. These projects are linked through the common theme of the problems of fragmentations in policy and practice leading to a lack of joining-up around a range of issues in health and social care service delivery. The three projects were: Virtual Electronic Social Care Record, Framework for Multiagency Environments (FAME) and Children's Service Directories. The statement details a three stage process from initial engagements in understanding the problem by reflecting on the process of integration which produced joined-ups within health and joined ups within social care and subsequently trying to solve the problem of care co-ordination between health. and social care contexts by attempting to join-up the joined-ups. Evidence is presented to show how such approaches lead to 'overintegration' where organisations and practitioners are unable to collaborate or co-ordinate appropriately which leads to a re-examination of the proposed solution of structurally driven integration. It concludes by suggesting that tightly coupled approaches are not the solution to the problems of joining up services in health and social care. Rather a looser and wider set of inter-organisational couplings supported by federable and governable services are required to deliver the sorts of joined-up services health and care envisaged by policy-makers and academics and outcomes desired by organisations, professionals, carers, patients and clients and wider society.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available