Complex care needs and devolution in Greater Manchester: a pilot study to explore social care innovation in newly integrated service arrangements for older people

Objective
To describe emergent approaches to integrated care for older people with complex care needs and investigate the viability of measuring it.

Methods
A case study approach was used. Sites were recruited following discussion with senior staff in health and social care agencies. Service arrangements were categorised using a framework developed by the researchers. To investigate joint working within the sites the Development Model for Integrated Care was adapted and administered to the manager of each service. Data were collected in 2018.

Results
Six case study sites were recruited illustrating adult social care services partnerships in services for older people with homecare providers, mental health and community nursing services. Most were established in 2018. Service arrangements were characterised by joint assessment and informal face-to-face discussions between staff. The development of an infrastructure to promote partnership working was evident between adult social care and each of the other services and most developed with home care providers. There was little evidence of a sequential approach to the development of integrated working practices.

Conclusion
Components of partnerships promoting integrated care have been highlighted and understanding of the complexity of measuring it enhanced. Means of information sharing and work force development require further consideration.