Throughout this programme, leaders and systems have been engaged at various stages in their journey towards integration at place. Leaders have been clear on the need to move from ambition to delivery and see tangible, measurable benefits from new integrated arrangements at place. However, the practical challenges to delivery in a complex environment are numerous. Five common barriers were frequently cited:
Some of these barriers will be more applicable than others to each provider and each place. While most systems will have encountered at least some level of challenge from all these areas, one or two of them may stand out as being particularly relevant in their context.
Prior understanding of (and early planning for) these barriers has been key to success for many places. Conversely, where places face these issues deep into a change journey, they can encounter real difficulty. It may not be possible to pre-emptively address barriers in their entirety, but it is often possible to address aspects of them. The concept of “going slow to go fast” was shared by, and resonated with, many of the systems.
For each of the common barriers highlighted, the experiences of the systems engaged in the programme have been synthesised. By doing so, some practical pointers for overcoming the barriers are shared and, where applicable, a selection of operational case studies of how places are working in new ways are included.
We hope that this publication will not be the end of the programme, but the beginning of a conversation. A series of events will be available to attend to explore the themes in greater detail and share experiences.
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