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Developing, implementing and evaluating integrated care models for infants, children, young people and their families
  1. Carol I Ewing1,2,
  2. Stephen A Cropper3,4,
  3. Timothy B Horsburgh4,5
  1. 1Royal Manchester Children's Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
  2. 2Research and Policy Division, Royal College of Paediatrics and Child Health, London, UK
  3. 3School of Social Science & Public Policy and Research Centre for Social Policy, Keele University, Keele, Staffordshire, UK
  4. 4Partners in Paediatrics, West Midlands, UK
  5. 5Clinical Lead for Commissioning of Infants, Children and Young People's Services, Dudley Clinical Commissioning Group, Dudley, UK
  1. Correspondence to Dr Carol Ewing, Royal Manchester Children's Hospital, Oxford Road, Manchester M13 9WL, UK; carol.ewing{at}

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For patients, commissioners, providers and regulators, ‘joining up’ of pathways of care, delivered through integrated service models, is an essential goal.

It is refreshing, therefore, that this publication ‘Integrating primary and secondary care for children and young people: sharing practice1 is in a format with which the children's workforce can identify and use. The paper makes reference to integrated care being ‘an umbrella term to describe initiatives which aim to address fragmentation of care between and within public services’. It draws attention to experiments which are making moves towards integration in infant, children and young people's (ICYP's) health services. It calls for investment in informed design, evaluation and research to develop a sound evidence base. Four key recommendations are made from five case studies about common foundations for innovation and change: stronger connections between paediatricians and primary care professionals, shared professional responsibility, workforce development, particularly in primary care, and new settings for specialist practice.

Despite continued advocacy and evidence for a more equitable focus on ICYP services2 these projects are not, in the main, centrally sponsored, and may be moving against the tide as implementation of the Health and Social Care Act 2012 may be further exacerbating fragmentation of care.

First of all, we examine enablers and barriers in policy and practice to develop and adopt effective integrated practice.

  • NHS England's Five Year Forward View recommends integrated and radical new delivery models, but focuses on elderly care services. Models of integrated care for ICYP require more extensive partnership working beyond social care to include youth justice and education systems so that ICYP, particularly with long-term conditions and complex needs, grow up to be resilient adults. Only one of 14 multispecialty community provider (MCP) model Vanguard sites is using a multidisciplinary team (MDT) approach for care planning …

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