Abstract
A need for people-centred health and social support systems is acknowledged as a global priority. Most nations face challenges in providing safe, effective, timely, affordable, coordinated care around the needs and preferences of people who access integrated health and social care (IHSC) services. Much of the current research in the field focuses on describing and evaluating specific models for delivering IHSC. Fewer studies focus on person-centred experiences, needs and preferences of people who use these services. However, current international guidance for integrated care sets a precedence of person-centred integrated care that meets the health and well-being needs of people who access IHSC services. This integrative literature review synthesises empirical literature from six databases (CINAHL; MEDLINE; AMED; TRIP; Web of Science and Science Direct; 2007-2019). This review aims to better understand the experiences and health and well-being needs of people who use IHSC services in a community setting. Twenty studies met the inclusion criteria and results were thematically analysed. Three overarching themes were identified, including relationships, promoting health and well-being and difficulty understanding systems. Findings of this review indicate that relationships hold significance in IHSC. People who access IHSC services felt that they were not always involved in planning their care and that there was a lack of clarity in navigating integrated systems; subsequently, this impacted upon their experiences of those services. However, service user and informal carer voices appear to be underrepresented in current literature and studies that included their views were found to be of low quality overall. Collectively, these findings support the need for further research that explores the person-centred experiences and needs of people who access IHSC.
Highlights
Over the past decade, an increased focus on the way that integrated health and social care (IHSC) services are delivered and a growing demand for improved service user experience have driven forward improvements in worldwide health and social care (HSC; World Health Organization, 2016a)
A lack of understanding of organisational cultures, repeated complex structural changes and ineffective communication are common barriers in IHSC (Burgess, 2012; Mason et al, 2015). These issues can impact upon the experiences of people who use IHSC, their families and professionals involved in their care, resulting in unmet needs (World Health Organization, 2018)
Service user needs and experiences of IHSC are explored in part; specific contexts limit the scope of some of these reviews; for example, service users who are homeless or living with long-term conditions (McGilton et al, 2018; Omerov et al, 2020)
Summary
An increased focus on the way that integrated health and social care (IHSC) services are delivered and a growing demand for improved service user experience have driven forward improvements in worldwide health and social care (HSC; World Health Organization, 2016a). Person-centred IHSC systems aim to follow principles of participatory care and governance, which are coordinated around service user needs These systems and strategies offer a balance between population health and wellbeing and ill-health prevention (Marks et al, 2011; World Health Organization, 2016b). A lack of understanding of organisational cultures, repeated complex structural changes and ineffective communication are common barriers in IHSC (Burgess, 2012; Mason et al, 2015). These issues can impact upon the experiences of people who use IHSC, their families and professionals involved in their care, resulting in unmet needs (World Health Organization, 2018)
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