New models of care: the policy discourse of integrated care

Abstract

New models of care are being pursued throughout England to balance increasing demand for improved health and social care services against reducing public expenditure. A dominant discourse has emerged about the value of community-based integrated care, despite failures of integrated care programmes to consistently demonstrate reductions in hospital admissions. Discourse analysis of integrated care policy establishes how issues of aging, hospital admissions and fragmentation are problematised, and how solutions of integrated care are made possible by the argumentative structures of the policy. These findings are discussed in relation to historical and political accounts of English health policy to identify the discursive conditions that contribute to making this discourse possible. It is argued that the policy of integrated care works as a discourse to manage tensions associated with health and social care funding, rather than as an intervention that can achieve a reduction in hospital admissions.