1. Dr Richard Harling Director of Health and Care
Integration in a single patch or person? Reflections on the future of integration 
Dr Richard Harling
Director of Health and Care

2. Core principles Issues Pooling of risk Asymmetry of information
Purchasing power
People arrange their own care
Social care self funders
Issues
Fragmentation
Personalisation
An agency arranges care on people’s behalf
Most NHS and social care
Direct payments

3. Integration by individuals
People arrange their own care
Issues:
People don’t know what is possible
They don’t feel sufficiently informed
They can’t manage transactional processes
Changes in the law have reduced purchasing power
Solutions:
Actively encouraging people to pursue this option
Providing good information about the services available and their respective merits and costs
Support to manage transactional processes

4. Integration by agencies
Issues:
Lots of agencies involved
Competing political, financial, organisational and professional priorities
Changing strategic planning ‘footprints’ and organisational forms
National command and control
An agency arranges care on people’s behalf

5. A framework for integration by agencies
Colocation
Processes and systems
Budgets
Governance
Teams
Relationships