Evaluating the structure and process of effective integrated care for people with multiple long-term conditions:...

Integrated care represents a transformative approach to delivering person-centred healthcare, aiming to reduce health inequalities, improve outcomes and boost system efficiency. The WHO advocates integrated care, which is also a central pillar of the UK government's National Health Service (NHS) 10-year plan. However, there remains a significant evidence gap regarding optimal organisational strategies for designing and delivering integrated care services. Multiple long-term conditions (MLTCs) refer to the coexistence of two or more chronic physical and/or mental health conditions in a person. This complex need requires coordinated support from multiple healthcare services, and individuals with MLTCs may particularly benefit from integrated care services. This review aims to identify and synthesise evidence regarding the organisational structures (care set-up) and processes (care delivery) that support integrated care models for adults with MLTCs.

An information specialist and research team will co-develop a search strategy and search databases (MEDLINE, EMBASE and PsycINFO) for empirical articles between January 1990 and December 2025. Date restrictions reflect the establishment of integrated care as a concept for organising and delivering health services. Screening, data extraction and methodological assessment using the Mixed Methods Appraisal Tool will be independently conducted by two researchers. Eligible studies include any empirical studies, including all study designs that investigate adults (aged 18+ years) with MLTCs in high-income countries. This review aims to identify the way integrated care services are designed and delivered. As such, studies must identify and explain the organisational structures and processes involved in implementing and delivering integrated care services to be eligible for inclusion. Extracted data will be categorised according to the two integrated care mechanisms: vertical and horizontal integration. Data will then be examined in relation to how these mechanisms function and/or interact across the macro (system-wide structures and policies), meso (organisational arrangements) and micro (clinical practice and patient-level interactions) levels of integrated care. Review findings will be reported narratively.

Ethical approval is not required. This work may directly inform health policy by providing evidence-based understanding of how to organise and deliver integrated care for people living with MLTCs. The findings will be disseminated through publication in a peer-reviewed journal and shared with relevant stakeholders.

CRD420251143298.