The governance of integrated health and social care in England since 2010: great expectations not met once again?

Integrating health and social care has long been a goal of policy-makers and practitioners. Yet, this aim has remained elusive, partly due to conflicting definitions and a weak evidence base. This article examines the governance of integrated care in England since 2010. It focuses on the extent to which the five governance attributes (transparency, accountability, participation, integrity and capability; TAPIC) are applicable to integrated care in England. The plethora of English policy initiatives on integrated care (such as the `Better Care Fund’, personal health budgets, and `Sustainability and Transformation Plans’) mostly shows signs of continuity over time although the barriers to integrated care often persist. The article concludes that the contribution of integrated care to improved outcomes remains unclear and yet it remains a popular policy goal. Whilst some elements of the TAPIC framework fit less well than others to the case of integrated care, the case of integrated care can be better understood and explained through this lens.