Changing patterns of care coordination within old-age services in England

There has been a focus internationally in recent years on policies and strategies to divert the long-term care of frail older people away from residential and nursing home care and enhance provision of community-based care by improving care coordination through increased differentiation within care management arrangements and service integration between health and social care. The aim of this article is to explore variations over time in care coordination arrangements within old-age services using data from national postal surveys of English local authorities. Indicators of differentiation and integration developed from earlier research were used to compare changes over time. There appeared to be some evidence of change relating to integration at both organizational and practice levels, but little change was detected in respect of differentiation within care management arrangements. The impact of the findings in the context of four enduring themes related to international case/care management literature--eligibility, integrated health and social care, shared information, and targeting--are discussed and the relevance of these in relation to possible future trends is explored.