The European Social Network (ESN) has been looking at existing policy and research in the field of integrated services through a literature review. The objective was to assess the state of play across Europe, which we presented in our Manchester seminar. Here are a few highlights from the literature and research session.
Service integration in Europe: it’s about structure - but most of all, about people
Sarah van Duijn from Vilans, with whom ESN partnered in this project, presented the main findings of the review. Beyond structural and organisational aspects, such as physical co-location or joint funding and goals, the findings showed that the human dimension was also crucial in enhancing service integration. This includes the interaction between professionals, trust building and the elaboration of commonly agreed goals.
Avoiding ready-made solutions and tackle complex challenges
Speakers highlighted the inadequacy of ‘one-size-fits-all’ models. John M. Davis, Chair of Childhood Inclusion at the University of Edinburgh, presented Scotland's assessment model for children’s inclusion, whose many variations all tend to produce a common outcome - a positive change in people’s lives. “There is no perfect family, said Mr Davis. We just support them to change to well-adjusted ones”. In Scotland, this is done through the ‘Getting It Right For Every Child’ (GIRFEC) policy, characterised by appointing a single point of contact for children and families, and placing the child’s well-being at the centre of every initiative. Moreover, all initiatives should take their environment into account, as seen in the “My World Triangle” approach.
Another example of the importance of place and context was brought forward by Ágota Scharle, from the Budapest Institute for Policy Analysis, who presented the lessons learnt from the study conducted for the European Commission on integrated employment and social services. She concluded that “the scale of the reform should be adapted to existing institutional framework and efficiency of public administration” in order to be successful, thus echoing the words of Ray James, President of ADASS, who also argued that “Place [mattered] […] and so do the people who live in it”.
Users at the centre
In long-term care, too, placing the user at the centre can improve outcomes, as shown by Kai Leichsenring, from the European Centre for Social Welfare Policy and Research. Mr Leichsenring presented an organic model of integrated long-term care, where informal carers, families, health and social care professionals come together to improve quality of life for users. Examples of successful service integration featured the joint needs assessments carried out by ‘Assessment tandems’ in Bolzano, Italy, and integrated health and social care budgets in Norrtälje, Sweden, where stakeholders – county, municipality, hospital, primary care centres, home care services - came together to define care pathways, discharge management and homecare services, eventually leading to fully integrated care and increased choice for users.
Despite a great diversity of situations and examples, current literature and research on integrated services show how public services, including employment, health, education and social services are on the path to providing more holistic support as a response to some of the challenges facing social welfare across Europe.