Last Updated on July 1, 2016

There is limited evidence to support the creation of new roles to deliver integrated care. Indeed, the available evidence suggests that working with the existing workforce to create more flexible and multi-skilled teams that can work across boundaries is as, if not more, effective, according to Supporting integration through new roles and working across boundaries, a new report published by The King’s Fund.

Supporting integration through new roles and working across boundaries examines the evidence for creating new roles, such as care navigators, as part of an integrated workforce – arguably the most important resource in delivering integrated care. The report found there has been limited assessment of the effectiveness of individual roles as most evaluations focused on the wider process of integration. There is also limited evidence of whether new roles can reduce costs.

Issues were also raised around how new roles often fail to address the cultural gaps between professional and organisational identities – like that between health and social care – which are essential in breaking down barriers to deliver integrated care. This could result in the task of integrating care falling on a small number of lone individuals, at the expense of engaging staff in support of integration more widely.

Instead, the King’s Fund’s analysis found some common factors that work in developing an integrated workforce.

• Many of the skills required to deliver integrated care exist within the workforce and can be more effectively shared and distributed as part of an overall system of care.
• Engagement with the workforce from the outset on the aims for integration and a focus on the needs of patients and service users can enable staff to take a lead in identifying innovative solutions.
• Wider organisational support and buy-in with appropriate management and accountability for staff is essential to ensuring integrated care solutions provide quality care and are sustainable.
• Acknowledgement of professional boundaries can serve to build trust and respect, which in turn can lead to greater role flexibility.

The report, commissioned by the Local Government Association and NHS Employers, concludes that it is crucial we reflect on what works in creating an integrated workforce. Examples such as multidisciplinary teamwork and integrated care pathways have proved effective and while new roles should not be dismissed, organisations should first address the fundamentals of integration before assuming that a new role is needed.

Supporting integration through new roles and working across boundaries is available to read here.