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Development of a framework for preparing organisations and teams for neighbourhood working


Kirsty Marshall

University of Salford, GB
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An aging population and a growth in long term conditions in the UK has led to dramatic changes in the demographics and epidemiology. The government has introduced policies focused on transforming the health and social care system into integrated care systems (Department of Health [DH], 2012). Research has shown that the transformation to integrated care systems is reliant on people and is often complex and convoluted requiring structural, practice, and cultural change (Bryson, Crosby & Middleton Stone, 2006; Cairns & Harris, 2011). Therefore, the growth and prevalence of long-term conditions and its link to social inequality is a significant concern for researchers and health policymakers (George & Martin, 2016).

The aim of this study was to explore the experience of a neighborhood team during integration. This was achieved through the presentation of their experiences from their perspective. Using an adapted institutional ethnographic approach.

The finding demonstrated that teams moved through a non-linear process of conversion and separation during integration. A principal factor was the narrative of integration, as it was through the narrative that, practitioners developed hope about the process. Alongside narrative, the leadership and cultural shift was a factor in the successes within the observed team. These results indicated that there were key considerations in the development of integration at a local level.

The team’s hope was not just for themselves but also, for better care for people.  Linking the hopes of the team, to a strong narrative for empowerment and engagement, represented a powerful motivational factor.  These findings were similar to previous studies, for example, Snooks et al (2011) reported that community members and professionals viewed collaborative approaches as important and equally, Coxon (2016), stated that, there was a relative consensus about the benefits of integrated working.  Additionally, the findings from this research add to the previous research, as they highlight the importance of a positive narrative, which can engage and motivate team members during the early transition. The movement toward integrated systems, therefore, benefit from a framework approach, rather than a structured change management approach. Based on finding a framework to prepare teams for integration has been recommended.

There were three key themes that developed in the research which, were conversation and separation as part of the integration process, the importance of hope as a driver and sustaining the force, and the importance of team-level leadership in the development of team-level change. The finding of the study was used to develop a framework for preparing teams for integration.

The study was a small ethnographic study over a nine-month period and any transferability of findings are required to be viewed through the scale and context of the study. The approach enabled a deep understanding of one case of integration, to strengthen and validate finding further research is required.

Further research could include the testing of the effectiveness of the framework in a range of settings. This will enable the strengthening of the framework and development of a package of support for organisations


How to Cite: Marshall K. Development of a framework for preparing organisations and teams for neighbourhood working. International Journal of Integrated Care. 2021;21(S1):32. DOI:
Published on 01 Sep 2021.


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