Publications from ODSW Social Insights: Letters by DSW (Vol 2) | Page 53

Working with Various Client Groups
Accessibility - Integration should aim to streamline access to services by
ensuring that older people receive a good, co-ordinated response to their
needs at any point of entry into the service system. Where possible, the older
person should be served by a regional cluster of services which is a form of
‘one-stop shop’ even though it may not be at one physical location. The aim
of this is to prevent unnecessary admissions to acute care or inappropriate
long-term residential care, by providing alternative integrated services and
improved support at home. Effective co-ordination among a wide range of
agencies and organisations may also provide opportunities for developing
communities and neighbourhoods that will support ageing in place.
Quality - Integrated care offers opportunities for better outcomes for older
people with complex needs when a holistic approach is taken, services
are co-ordinated, and there is continuity of care. This, however, does not
necessarily translate into a seamless and timely delivery of care in the home
of the older person as there are resource constraints. It is about having safe
and appropriate service delivery that is based on assessed needs.
Financial sustainability - Integrated approaches in care for older people with
multiple or complex needs should result in more efficient and cost-effective
solutions for health and social care systems.

Barriers to Integration
Sometimes, just by removing or lowering the barriers to integration will
also result in improvements. Some of these include separate funding
systems for health and social care, cultural differences and problems related
to organisational, structural and professional boundaries. Given these
considerable challenges, it is important that integration is not seen as the
answer to every issue but one that focuses on resolving problems for which
some kind of co-ordinated response is essential. These are problems that
have been described as ‘wicked issues’ because they are hard to define and
have unclear causal chains and complex inter-dependencies.

Starting Integration with a Shared Vision
One might ask why having a shared vision is particularly relevant for
integration in social care? This is critical as social care is provided by a range
of organisations and sectors – statutory, voluntary or non-governmental,
private, professional and community – that have very different perspectives,
agendas and values. The challenge then is how to bring about this “working
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