1. Change management driven by champions
sustains and rolls out good practice
commitment and flexibility to solve ongoing problems
rewards success
managed as a whole system
presses on regardless
not willing to devolve responsibility
bogged down in organisational problems

2. Cross profession engagement
sharing information and skills for the bigger picture
open, honest, transparent communication
shared records – creative use of IT
centred on user need
‘we all own this’
lack of trust
tribal, protectionist
‘WE own this’

3. Integrated health + social care teams
Shared commitment to goals and objectives
Interdependence of outcomes
Clarity on role and accountability, including leadership
Cultural congruity
Focus on quality + innovation
True co-operation
Interprofessional trust and respect

4. Integrated budgets
‘integration in health and well-being services can be cost effective – however the evidence base is still relatively small’ (Turning Point, 2010)
transparency
accountability
clarity

5. Leadership Long-term commitment, enthusiasm, involvement
Shared vision and goals across partners, communicated to all
Proactive promotion
Building commitment, understanding, shared culture
Achieving targets

6. Checklist for self evaluation
Consultation with staff
Common language
Strong leadership and vision
Staff development
Clear identities
High quality information systems
Continuity and stability
Respect differences
Right people with right skills
Risks identified and managed
Clear decision-making and accountability
Shared efficiencies
Cost monitoring

7. Key issues Implications beyond older people
Agreed national outcomes mixing personal and organisational
Partnership with third and independent sector
Leadership capacity
Collaboration between health clinicians and social care professionals
Achievement of integrated budgets