CRITICALLY DISCUSS

Critically Discuss Some Of The Key Issues Informing Early Year's Education And Care Policy Under The New Labour Government

Critically Discuss Some of the Key Issues Informing Early Year's Education And Care Policy Under The New Labour Government

1. Introduction

Integrated care is characterised by coherent and coordinated service delivery to individual service users across a broad range of health and social care organisations, various professionals and informal caregivers , and . In Europe, the need for integrated care is evident as all health and social care systems face the same fundamental problem: the burden of disease is shifting away from those suffering from acute illness towards those with long term conditions and multiple co-morbidities. Clearly, this requires the joint efforts of cure and care providers in multiple institutions . However, poor coordination dominates at all levels and is exacerbated by the existence of dividing lines between sectors - the English even speak of 'Berlin walls' between health and social care - and among governing bodies, health and social care organisations, and professionals. The results are manifold, e.g. conflicting medical regimes and recommendations to patients, duplication of diagnostic procedures and poor transferral from one care provider to another and . They also include inter-organisational struggles and miscommunications as well as conflicting regulations and financial regimes. As a consequence, inefficiencies, higher costs, consumer dissatisfaction, restricted access, and poor quality and continuity of health care services occur .

2. Methods

This paper is based on a secondary analysis of reports, written by a small European network of scientists with expert knowledge on integrated care policies and practices in their respective countries. The reports were presented in a book entitled 'Integrated Care in Europe'. This book described the nature of integrated care in various European countries, derived lessons from the comparison of countries, and presented practical tools . Most of the data on integrated care policies and practices were collected over a period of approximately 10 years, namely the 1990s and early 2000s. The specific literature and documents studied by each expert are mentioned in each report's references section , , , , and . Because evidence from this book is based on data from the late 1990s and early 2000s, we will compare the results presented in the book with the results of similar, more recently published studies in order to determine whether our concepts and conclusions are up to date, relevant, and valid.

The authors of this paper participated in the editorial committee for the book and designed a descriptive framework using their earlier research (e.g. , and ). This was done to ensure the comparability of the different country descriptions. The framework comprised the following aspects:

1. Principal characteristics of the national health and social care systems: the structure of the national health care system, legislation, funding, policy developments on integrated care, key players, and sub-national variations.

2. Target groups of integrated care, such as the elderly or chronically ill.

3. Integrated care providers and services, which includes various care sectors, providers, and provincial or local ...