Breadth of Ambition


Integrated care includes many levels of integration, such as integration between primary and secondary care, of all stakeholders involved in the care process, or across many organisations. It may be developed simply for healthcare needs (i.e., vertical integration) or it may include social workers, the voluntary sector, and informal care (i.e., horizontal integration). The broader the ambition, the more numerous and diverse the stakeholders who have to be engaged. Similarly, integration may include all levels of the system or may be limited to clinical information sharing. The long-term goal should be fully integrated care services which provide a complete set of seamless interactions for the citizen, leading to better care and improved outcomes.

  • Integration supported at all levels within the healthcare system – at the macro (policy, structure), meso (organisational, professional) and micro (clinical) levels.
  • Integration between the healthcare system and other care services (including social, voluntary, informal, family services).
  • Seamless transition for the patient between and within care services.

Indicators of maturity:

Evidence of successful integration as viewed by the citizen; both vertical and horizontal integration; strong connections between organisations based on protocols, service level agreements, contracts and (if required) mergers.


  1. No level of integration
  2. Services in silos; the citizen or their family as the integrator of services
  3. Integration within the same level of care (e.g., primary care)
  4. Integration between care levels (e.g., between primary and secondary care)
  5. Integration includes both social care service and health care service needs
  6. Fully integrated health & social care services.


Back to top