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2016 Conference Presentation

Care integrationFunding/purchasingMarkets/regulation United Kingdom

5 September 2016

Ageing and disability: the role of financial and regulatory incentives in facilitating intersectoral collaboration

A-La Park, PSSRU, London School of Economics and Political Science, United Kingdom
David McDaid, PSSRU, London School of Economics and Political Science, United Kingdom


Many individuals with long term disabilities are now living to old age, while ageing itself is associated with an increase in functional limitations and disabilities. Potentially there are benefits to be gained not only by sharing knowledge and experience but also through better collaboration for the delivery of long term care and support. Examples of opportunities for greater collaboration include supporting people with a disability to ‘age in place’ like other members of the general population and in moving to appropriate residential care when their needs change and can no longer be supported in the community. Older people ageing into disability may equally be able to benefit from some of the supports and innovations that have been used to support younger people with disabilities to help maintain independent living. Historically, however, there have been significant structural and practical barriers to between ageing and disability structures and organisations.

This presentation looks at how financial and regulatory incentives can be used to facilitate intersectoral collaboration and partnership working. It reports on findings from a systematic review that examined evidence from the last decade on different funding and regulatory mechanisms to promote intersectoral collaboration including between ageing and disability organisations and structures. Eight databases were searched: Medline, CINAHL, Psychinfo, ERIC, Business Source Complete, the International Bibliography of the Social Sciences (IBSS), the Social Care Institute of Excellence database and Econlit.

This review indicates that there is now a significant literature on financing arrangements to help facilitate joint actions between the health and social care sectors; however there are few examples of how the pooling of budgets and regulatory agreements for joint working have been used explicitly to bring the ageing and disability sectors together. These examples do suggest that the pooling of funds can in some circumstance help reduce administration and transaction costs, generating economies of scale through pooling of staff, resources and purchasing power, and facilitating more rapid decision-making. There appears to have been relatively little focus on assessing the impact of these measures on final health and disability-relevant outcomes.

Key indicators for success in bridging include the way in which arrangements for joint funding have been developed; arrangements that are voluntary in nature take more time to develop but appear to be more stable than mandatory arrangements imposed by government. Co-location of staff and functions of agencies sharing budgets is another facilitator. Quantifying the economic costs and benefits of enhanced intersectoral working is also helpful in building support for cooperation when benefits to both the disability and ageing sectors are highlighted. Disability and ageing sector partners need to perceive the pooling of resources to be in their own interests, adding value to what they can achieve in isolation.

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