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Care management in the 21st century : persistent challenges in implementation in the context of the emergence of self-care

Stewart, Ailsa and MacIntyre, Gillian (2013) Care management in the 21st century : persistent challenges in implementation in the context of the emergence of self-care. Journal of Integrated Care, 21 (2). pp. 91-105. ISSN 1476-9018 (In Press)

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The purpose of this paper is to examine the persistent challenges in implementing care management within the context of integration. In addition the appropriateness of the care management model will be considered within the current, personalisation focused, health and social care policy landscape. The paper draws upon a recent evaluation of a care management and assessment pilot project within a health and social care partnership in Scotland. A multi-method approach was adopted, including interviews, vignettes and focus groups, in order to capture data around expectations in relation to the pilot as well as exploring processes and outcomes for those involved. This paper argues that whilst progress has been made with regard to care management, specific and persistent challenges remain. Professional and organizational boundaries, communication and information sharing remain key challenge. Policy imperatives have shifted the emphasis in community care services towards self-care, co-production and personalization contributing to a lack of clarity over the place of care management within the broader integration agenda. This research was undertaken in one partnership locality in Scotland and as such the findings are related to that particular area. However, the key messages arising from this paper resonate with the broader academic literature on care management and as such are likely to be of interest to a broader audience. This paper brings together integrated working, care management and the developing policy framework of self-care to consider the challenges for care management in this context.