A reason to be cheerful
(about integrated care)
Jon Glasby, Helen Dickinson & Robin Miller
Journal of Integrated Care editors from 2013-2018
As we celebrate the 30th anniversary of the Journal of Integrated Care, it’s rare to find a policy and practice issue that endures for this long – and which is so common to health and social care systems around the world. Lots of policy ideas come and go, key personnel move on and things that were urgent one moment can be yesterday’s news quite quickly afterwards. Yet this hasn’t been the case with ‘integrated care’ and the need to better coordinate support across sectors and between professions. The work of the Journal is still as important as it was when it was first founded on the back of debates about the UK’s community care reforms in the early 1990s.
Our tenure as the editorial team began in 2013. In that year, twelve partners in England committed to a national framework for integrated care, Scotland were finalising the detail of landmark legislation to formally embed duties and structures of integration, and the World Health Organization (WHO) was building towards its global strategy for people-centred health services. Our first edition was guest edited by Richard Humphries of the King’s Fund and focussed on health and well-being boards which (unusually) in an English context are still in place a decade later. Such special editions played an important role during our tenure in generating discussion of often neglected aspects of integrated care such as housing, the voluntary sector, and social care within a general practice. Broadening the scope of integrated care and therefore a more holistic support for people and communities has been a major contribution of the journal before and since.
Reflecting on our times as editors, there are a number of things that strike us – both about the journal itself and about the issue of integrated care:
- In our first editorial we noted that research and practice are “two sides of the same coin and should always go hand in hand”. Because of its relevance to practice and policy, the Journal has always had to be quick off the mark, flexible, responsive, and current. Practice colleagues may not know this, but it can sometimes take years to get a journal article published in some academic outlets, yet the Journal of Integrated Care works hard to fast-track a number of these processes and to turn round highly policy- and practice-relevant material so that it appears in a timely fashion. It’s also been willing to support new contributors, whether academics from other disciplines relatively new to integrated care, or practitioners and policy makers perhaps writing an article for the first time. It’s very rare for Journals to be able to work directly with first-time authors to help them shape their material, and lots of us over our careers have benefitted from the advice and support we’ve received from the Journal.
- Within the UK, most debates about ‘UK health and social care’ usually refer to England as the default, and we lose major opportunities to learn from each other in an era of devolution. The Journal of Integrated Care has therefore played an important role in thinking about integrated care in all four nations and sharing lessons across geographical boundaries. Over time, the Journal has also become much more international in its outlook, initially through gathering international perspectives and in more recent time through research based outside the UK. The opportunity to learn from other systems shouldn’t be under-estimated. Whenever you place your own immediate issues in a broader context, you gain a more critical eye and the ability to ask more searching questions of your own practice and approach. You may learn a practical lesson to apply in your own system and be reassured that you’re not alone in your struggles to develop more integrated approaches.
- One of the reasons for the Journal’s success over time, has (perhaps unfortunately) been that lots of the same debates and issues recur over time – suggesting a real lack of policy learning, and an ongoing tendency for policy makers to over-promise and under-deliver. Sometimes this can make it difficult not to get frustrated – but the Journal’s focus and its ‘stickability’ is nonetheless helpful for current policy makers and practitioners who are struggling with these issues in the here and now, irrespective of what may or may not have gone before. It’s clear that there are no easy answers, however the continued strength of the journal is testimony that people want to do all they can to meet need in a more joined-up way.
Thirty years on, it’s inspiring to see the affection with which the Journal is greeted, and the commitment of those who contribute to it, organise it, subscribe to it and learn from it. Being involved with the Journal of Integrated Care – as authors, reviewers and editors – has been a joy and a privilege. Our final editorial was titled ‘reasons to be cheerful (about integrated care) – this journal undoubtedly remains one of these reasons.