What are the factors shaping service integration and delivery across local health, care, and voluntary sectors?
In England, Integrated Neighbourhood Teams are set up to provide local, joined up, and personalised care to people. These teams include staff from health services, social care, and voluntary or community groups, working together to support local residents. With changes to the health system expected in Autumn 2025, it’s important to understand what helps these teams work well together, and what makes it harder. Trafford Council in Greater Manchester wanted to understand the research evidence on this to help plan better local services in their neighbourhoods.
What did we do?
We used rapid evidence synthesis methods to find research that answered this question: What ‘factors’ help or hinder integrated neighbourhood teams working together across health, care, and community organisations?
We looked for both primary research and evidence syntheses, finding 26 relevant studies, including 9 primary studies based in the UK and 17 evidence syntheses.
What did we find?
We found that there was strong agreement in the research evidence about what helps teams work well and what can make things harder. The most important factors were:
- Having a clear, shared vision and purpose
- Strong leadership
- Good working relationships based on trust and respect
- Clear roles and responsibilities between professionals
- Stable and ongoing funding and resources
- Involving patients and the public in plans
- Opportunities for staff to learn and develop
- Teams being co-located together in the same place
- Regular time set aside for multidisciplinary team meetings
- IT systems that work together and allow safe data sharing
Most of the studies we looked at investigated local integrated care across different services and patient groups rather than integrated team functioning within specific services or groups. However, there was some evidence that the above factors are still relevant in shaping the delivery and function of integrated services caring for particular patient groups (e.g., many of the same factors affected integrated team functioning across many difference services, such as those caring for frail elderly people and those for patients with mental illness).
Most studies looked at local integrated care in general, rather than focusing on specific services or patient groups. However, there was some evidence that these same 'help' or ‘hinder’ factors applied across different types of care - for example, whether the team was supporting frail older people or people with severe mental illness.
There wasn’t much evidence on the best size of these teams or how wide their reach should be (for example, how many organisations or areas they cover). More research is needed to understand the best size and structure for these teams.
Overall, we found that there is strong agreement across these studies on the relational and organisational factors that support the functioning of integrated neighbourhood teams. From these findings, we were able to produce a checklist of actions to optimise service integration and delivery for integrated neighbourhood teams. This practical framework can be used to support policymakers, commissioners, and professionals when planning and implementing integrated neighbourhood teams.