Removal of Inhibitors


Even with political support, funded programmes and good eHealth infrastructure, many factors can still make integrated care difficult to deliver, by delaying change or limiting how far change can go. These include legal issues with data governance, resistance to change from individuals or professional bodies, cultural barriers to the use of technology, perverse financial incentives, and lack of skills. These factors need to be recognised early, and a plan developed to deal with them, so as to minimise their impact.

  • Actions to remove barriers: legal, organisational, financial, skills.
  • Changes to the law concerning e.g., medical acts, information governance, data sharing – factors which may hold up innovation.
  • Creation of new organisations or collaborations to encourage cross-boundary working (‘normative integration’).
  • Changes to reimbursement to support behavioural change and process change.
  • Education and training to increase understanding of ICT and speed up solution delivery.

Indicators of maturity:

Laws to enable data-sharing; financial incentives aligned to teamwork and outcomes (value rather
than volume); training programmes to fill skills gaps; formation of new organisational structures or
contracts between organisations to deliver integrated care.


  1. All projects delayed or cancelled due to inhibitors
  2. Some projects delayed or cancelled due to inhibitors
  3. Process for identifying inhibitors in place
  4. Strategy for removing inhibitors agreed at a high level
  5. Solutions for removal of inhibitors developed and commonly used
  6. High completion rate of projects & programmes; inhibitors no longer an issue for service development
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