Community first: a systems approach to implementing integrated care

Purpose Integrating health and social care services is a longstanding aspiration in England, but the question remains as to how to achieve it. This article compares the implementation approaches and its enablers and barriers of a strengths-based intervention (community-led support, CLS) in two sites, one led by a health organisation, i.e. National Health Service (NHS) and the other by a social care organisation, i.e. local authority. Design/methodology/approach This study was part of a wider research project that examined the implementation of CLS within five areas in England. A qualitative research design was adopted, drawing on seventeen semi-structured interviews with managers and frontline staff leading the implementation of CLS across health, social care and voluntary sector organisations. Data was analysed inductively for each site before comparing emerging codes between the sites. Findings Supportive leadership structures at various levels, a shared vision, pre-existing relationships with other sectors and introducing champions were helpful factors to adopt CLS. However, staff anxieties towards creative ways of working, the lack of involvement of individuals with lived experience and the insufficient integration of processes and systems hindered embedding CLS across the whole system. Originality/value Emphasis on a community oriented approach encourages local innovation based on the needs of a community. This study provides helpful insights into aspects supportive of implementation while highlighting unique challenges arising from integration.