European “Lifelong Learning” Programme, Leonardo Da Vinci, “Transfer of Innovation” Action What integration is. Analyzing different integration forms and presenting their features Karaberi Christina, EU Project Management (e-Trikala SA) “PRISSM” 1 ο Workshop, Trikala February 2014

What integration is The totality of approaches and methods aiming to a better coordination and greater efficiency in the cooperation between different services Main objective: Achieve optimal results Satisfy users through services offered Cost cut at the level of design, organization and operation of the said services Integration can be either partial or total.

Fragmented services (autonomy) Services coordination Integrated model of structural integration Different integration levels Every level has internal classifications Structural is not always optimal No classification is superior than the others Selection depends on the service status, the objective and institutional practices

Vertical and Horizontal Integration “a single planification and/or service provision system which is implemented and is jointly managed between partners (allied bodies), which either remain independent at a legal level or are legally interdependent.” vertical integration in the macroeconomic scale regards measures which are taken for a closer coordination between bodies and the management of services at different levels (national, regional and local) Horizontal integration: these are measures which aim to gather big public services under the same roof, divided up to now

Integration, but why?

Different integration levels Autonomy Coordination integration 1. Fragmentation of services υπηρεσιών 2. Connection 3. Intersectorial work 4. Cooperation ad hoc 5. network 6. One stop shop 7. partnership 8. Structural integration 9. Case management

Autonomy 1. fragmentation/ separation of services - Control of one service is not transferred to another - Special duties of one service are not absorbed by another service - Decision making process is independent -Complete lack of coordination between public services - Systems are rigid, there is distinction at all levels, approach is purely standardized - There is a lack of a total approach to the users needs

Autonomy 2. Connection between services - Organizations come to agreements - They create channels to disseminate information - They adopt protocols to facilitate future cooperation, to better meet the needs of users - The organization still works in an autonomous way: it has its own rules of acceptance, evaluation, administration and decision making procedure

Different integration levels Autonomy Coordination Integration 3. Intersectorial work 4. Cooperation ad hoc 5. network 6. One stop shop 7. partnership 8. Structural integration 9. Case management

Coordination 3. Intersectorial group/work - It can quickly apply to a local level - It mainly focuses on the procedure/mission and not on the structural integration of bodies undertaking the task of different services - Very limited (local range) - Very weak formalism: planning is needed, consultation and preparation of the personnel and empirical planning of the mission

Coordination 4. Cooperation ad hoc - Dissemination of the information - Action (related to the past) - Possible understanding of the need to adopt a higher integration level - Limited range: given that it is linked to crisis, there is no official commitment for a greater integration of different services

Coordination 5. Network - Professionals voluntary organization sharing the means and resources for the same group of users - Planned approach - Bodies structure maintenance - Intense dissemination of information -Measures to strengthen cooperation - A step towards an integrated system - Low cost and less significant changes - Consultation procedure for decision making - Uncertainty about the level of organizational commitment

Cooperation 6. Service or one stop shop - Access to multiple services in one building - Close cooperation perspective - Better exchange of information and joint work of different services personnel - Intense promotion in local society - Simplified procedure for users - Intense level of organizational commitment - Create services in standard supermarkets - Orientation difficulties in the case of a welcome service absence

Cooperation 7. Partnerships The development of a formal/informal partnership has three main objectives: offer coordinated services to users, satisfy the general interest/solve problems which go beyond the limits of traditional services and professional boundaries mitigate the impact of an organizational fragmentation, absorbing any negative impact The partnership model which will be selected shall depend on many factors: local particularities, preferences of partners and cost related issues.

Coordination 7. Partnerships - Better adaptation of services to users needs - Better use of resources (accompanying procedure) - Better information exchange (common use) - Adoption of creative approaches, experimenting, innovative service improvements - Better promotion and position in a competitive system, economies of scale - Difficulty in evaluating the cost of benefits resulting from partnership

Different integration levels Autonomy Coordination Integration 8. Structural integration 9. Case management

Integration 8. Structural Integration (merge) - Users do not know where to address - Simplification of the decision making procedure (involved employees reduction, communication problems decrease, quick response to specific needs) Positive ratio of cost/effectiveness (economies of scale) - Adoption need through restoring decisions - Deviations in the culture of different services merged - Lack of sufficient or direct public services financing - System complexity - Shortage/weakening of the responsibility - Integration becomes a goal in itself and the users’ needs come second

Integration 9. Individualized management/case management Individualized management (sometimes called “care management” or systematic patient monitoring) is a services integration model at the level of an individual user. The notion of “seamless care” demonstrates how users should ideally perceive the provision of services – for instance social or health services – meeting their special needs.

Integration 9. Individualized management/case management The provision of such coordinated services allows for the more vulnerable ones to remain home: These services are indeed considered more sure, more effective and more suitable compared to other solutions. Moreover, it contributes to decreasing bureaucracy, ensuring better access to social rights and strengthening social cohesion, improving the quality of services, reducing the cost of services provision for the organization

Different integration levels Autonomy Coordination Integration 1.Fragmented services 2. Connection 3. Intersectorial work 4. Cooperation ad hoc 5. network 6. One stop shop 7. Partnership 8. Structural integration 9. Case management Structural integration is not optimal No level is superior to others Selection depends on the service status, the objective and institutional practices