Integrated care and the ‘agentification’ of the English National Health Service

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Journal Article
Social Policy and Administration, 2021, 55, (1), pp. 173-190
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Integrated care is a global reform principle for improving patient access and outcomes by ensuring that healthcare organisations deliver services in a joined-up, person-centred way. Following reforms designed to infuse agency within English National Health Service (NHS) organisations, the agenda for integration must come to grips with the different approaches to joint working that these organisations mobilise, and the compatibility of their different agentic orientations. We build a matrix for identifying the extent to which different forms of agency orient nine NHS organisational types. Interrogating the Strategic and Operational Plans of these organisations for the period 2015–2018 based on questions derived from the matrix, we associate each organisation with one of eight generalised models. Assuming that there is greater potential for integration where organisations mobilise similar forms of agency, we discuss the incentives and potential governance changes that policy makers might consider to enhance integrative potential.
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