Whether addressing the challenges of faulty care continuity in hospital discharge or inequitable support for vulnerable people, smarter caring requires a new way of working across health and social care sectors. Jon Glasby provides a comprehensive, up-to-date account of national and state policy initiatives that seek to build new integrated care models.

Glasby argues that the conventional thinking of separating health and social care into self-contained areas has problematic implications for inter-agency coordination, service provision and distribution of responsibility. In the light of growing evidence about the wider determinants of health, he considers how to overcome these barriers through the introduction of legal obligations for NHS organizations and local councils to work together, policy frameworks that align goals and standards and the development of new data infrastructures.

The author focuses on three key examples of integration: health systems working to screen patients for social risks in primary care clinics; community groups building new cross-sector partnerships; and government-supported pilots of financing social care with healthcare dollars. He concludes that these initiatives are promising, but a more robust approach is needed for integrated care to be successful. This includes validated measures of social risk, better engagement of frontline staff in the process and greater flexibility from national policymakers to allow for alignment of incentives for both healthcare and social services providers.

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