30th anniversary issue editorial

Axel Kaehne

Journal of Integrated Care editor from 2018

This virtual special issue is produced for a very special and happy occasion: The Journal of Integrated Care is celebrating its 30th Anniversary this year.

Turning 30 may be an opportune moment to review the journal’s journey over the last three decades, acknowledge the lasting contributions of its former editors in chief, authors and reviewers and look ahead at what the future holds.

This journal owes its existence to Peter Thistlethwaite who founded the journal in 1992, 16 years after the NHS and local authorities had gone separate ways in England and Wales. Peter steered the journal during its initial decades and it became the flagship publication for practitioners in health and social care services with an interest in collaboration and integration across professional and organisational boundaries. As his reflection piece in this anniversary issue reveals, the field was marked by challenges that, up until now, have proved resistant to change. As England’s health service went through re-organisation after re-organisation, the divide between health and social care stubbornly refused to go away, despite the heroic efforts of frontline practitioners and researchers again and again exploring promising avenues for positive change. Different funding models for both sectors did not help either in bringing health and social care delivery together.

The journal provided a steady voice for those who articulated a different vision of health and social care, one that transcends service divides where patients experience care seamlessly. The journal published papers which became milestones on the way to a more continuous and seamless delivery of patient care. Whilst its attention remained focused on development in England, it quickly became a key forum for practitioners and academic researchers discussing new service approaches.

As the ideological orientation in health policy changed from emphases on professional and organisational autonomy under Labour in the early decade of the 2000s, then onto a more market approach under the Coalition government, health policy came full circle as more recent governments have brought the NHS back into central political control and stressed partnership as the predominant mode of cross-sectoral collaboration. Under the editorship of Jon Glasby (editor in chief) and Robin Miller (associate editor), the journal spread its wings and adopted a more international perspective giving readers insights into integrated care elsewhere. A special issue on Australasian integrated care remains one of the most downloaded issues of all times.

When I took over the journal in 2018 the key task was to increase the internationalisation of the journal to face the challenges of tomorrow whilst at the same time to maintain its relevance to local and regional integration issues, in the home nations of the UK as well as across Europe. Integration is a fiercely local issue in so far as it is defined and informed by local circumstances and national policy contexts. Cross border learning is thus dependent on robust evidence that is well contextualised and based on rigorous research methodologies.

The journal has approached this challenge in two ways. We consistently enhanced the pool of expertise available to the journal by significantly expanding the editorial board. We are proud to have welcomed colleagues from Brazil, Argentina, Netherlands, Canada and New Zeeland to the board who make a critical contribution to the journal.

On the other hand, we have stayed true to our roots in local practice. The journal continues to encourage and embrace exciting new voices, be they early career researchers or practitioners who are reflecting on how to improve collaborative work to improve patient care on a daily basis.

This has brought the journal a windfall in submissions increasing its output by almost 80% in the last two years. The journal now offers papers on a diverse range of topics and themes and has become the journal of choice for policy makers in Europe and elsewhere to publish viewpoints and papers dealing with key transformations such as digitalisation and integration.

If there is one lesson I have learned from the last couple of years at the helm of the journal it is that things do not stand still and neither can the journal afford to. The COVID pandemic has demonstrated how quickly long-standing collaborative arrangements can be swept aside and be replaced by emergency response systems guided by the primacy of public health concerns. Integration, if it is to survive the COVID shock to the health system has to reinvent itself and overcome its (previously justifiable) fixation on organisational and professional boundary research. In future, integration in health systems will occur in, and through, new modes of working, often based on digital means. Telemedicine will throw up new challenges of how to coordinate clinical and non-clinical practice effectively, and health management is currently undergoing a revolution as a response to a pandemic that is not over yet.

Integrated care will need to find answers to these questions and do so fast to remain relevant to provide an important voice in this conversation. That is why the journal has started calls for papers on digital technology as well as on COVID and its impact on integration.

The journal would not be where it is today without its wonderful contributors, its authors and reviewers. We owe a special thanks to them for their enormous help and support over the decades. It is to them and the readers that we dedicate this Anniversary Issue which brings together some new pieces from our former editors as well as some outstanding articles that have been published over the years in the journal. Enjoy!