Developing a competency framework for integrated care working across healthcare, social care and allied professions

Abstract

Background/Aims For integrated care to truly become embedded in the UK health and social care system, there is need for a shared understanding of what integrated care looks like at the local level. This study aimed to identify the competencies and behaviours required for working across the full range of health and social care services in the Bedfordshire, Luton and Milton Keynes Integrated Care System. Methods A multi-method approach was used to develop and refine the competency framework. An extensive evidence review of academic and practitioner literature was used to create the initial framework by synthesising previous frameworks. Four multi-agency focus groups were held to conduct utility testing and refine the framework. Quantitative testing was carried out using an 89-item online survey, including questions on the framework, a range of personal and work-related outcomes, and demographic characteristics. The survey was distributed to staff working across 13 different agencies within the integrated care system. Associations between variables were assessed using Spearman's Rho, using the Statistical Package for the Social Sciences. Results The evidence review identified 21 relevant competency frameworks, originating from nine different countries, which were used to create the integrated care competency framework. A total of 91 staff members completed the survey, with results showing acceptable reliability and validity of the final framework (item total correlation >0.2; inter-item correlation ≤0.9). Differences were found between agencies and occupational groups in terms of their integrated care competencies. Those with shorter tenure described greater use of integrated care competencies. Those who demonstrated more integrated care competencies also saw their work as more meaningful and enjoyed greater levels of support from their peers. Conclusions This is the first UK framework of integrated care competencies to be subjected to empirical testing. Initial testing supports the validity and reliability of the framework, as well as showing the positive outcomes associated with integrated working. This framework could be developed and rolled out on a wider scale to support integrated care working.