Publications from ODSW Social Insights: Letters by DSW (Vol 2) | Page 54

Working with Various Client Groups
together” amongst the many organisations and sectors. Governmental
agencies can play a crucial role in getting the systems more aligned if not
integrated as a first step and in getting systems and possibly networks
to adopt a collaborative and integrated working style. Integrated care
is a means to an end and the end goal and rationale for it needs to be
embraced by the various agencies. There is no doubt that we all share the
noble desired outcome of making sure that older people have a comfortable
quality of life and that they and their carers are listened to, have some say in
the services they use, and are in control of their situation and in the setting
of their choice.

Range of Services
Almost every wish list often show that a pre-condition for integrated care is
to have a full range of services available, across health, social care, housing,
transport, education, leisure and other sectors, and to ensure that they are
accessible to users. Services need to be delivered across organisational
boundaries, with clear access points and pathways, and with ways of
assessing and guiding older people through them. In essence, services need
to work together as a single, comprehensive, integrated whole system. ‘A
whole system approach which places the older person at the centre will
benefit older people by providing the right support, at the right time and
by addressing the entire range of their needs’ (Carrier 2002) 1. The irony
is that there is perhaps no model of good integrated care because good
integrated care comes from the context of co-ordination and a commitment
to working together as ‘integration’ has a number of dimensions. Integration
may be described along a spectrum ranging from tolerance to co-operation,
joint planning and in our context inter-ministerial and national committees
comprising both governmental and non-governmental representatives, as
well as partnerships and joint projects.

Working across Processes and Systems
While we have a shared direction and approach towards integrated care,
there is much that can be done to join up processes to enable structures to
work better.
As a guiding principle, we need to keep in mind that integrated care has
to be appropriately targeted and that integration is not the solution to all
problems. For sustainability, policies must support differentiated responses
to complex and simple needs to ensure cost effective and appropriate
responses.
1

Carrier J (2002). Integrated Service for Older People. Building a whole-system approach in
England. London: Audit Commission.
53