1. Integration isn’t enough
Martin Routledge

2. Individual level integration
Integration now central to health and social care policy
But most attention is paid to structural and service integration
Vital to explore integration at the level of and directed by the individual
Self-management and health and social care personal budgets can play an important role, especially with long term conditions and “wicked issues”

3. Kings Fund model for older people Oliver, Foot and Humphries 2014

4. Control as well as co-ordination
Better use of shared resources
Effective interventions
Co-ordinated professional support
Care in people’s own homes and communities
Good planning with individuals and families
Support for self-care and management
Information about options and choices
People exercising control over their care

5. Co-production – a win-win
Personal health budgets evaluation replicates research in social care:
Better well-being outcomes for people with LTCs, reduced use of hospital, cost effective especially for people with the highest needs
Best results achieved when: people know £ up front; advice and support available; choice and flexibility over how to spend budget , choice on how it is managed

6. To share power we will need to:
Drive co-production into all areas of commissioning and delivery of key local services
Measure the things that are important to users of key public services and use the results to drive local developments
Lever and incentivise new or currently marginal forms of care and support
Drive integrated personal budgets with a strong focus on those areas which would be of major benefit for people using them while helping to address significant system financial challenges or "wicked issues
Lever and support the re-targeted use of professional skills and capacity

7. Consensus?
People are often the best integrators of their own care and support : Norman Lamb October 2013
People are active citizens, with whom power and responsibility must be individually and collectively shared: Liz Kendal March 2014