Intersectoral coordination and multiprofessional teams: merging primary care and social services

Abstract Background Since the 2000s, integrated care has been a policy aim in Finland. Reforms for creating larger care authorities have failed at national level, but municipalities have established regional joint health and social integrated care authorities. Our study focuses on integration of services for children and young people and adults’ psychosocial care. The aim is to evaluate integration in terms of success and its underpinning factors in two authorities with merged primary and specialised healthcare and social services. Methods South Karelia and North Karelia were selected as case studies, because these regions were pioneers in establishing integrated care authorities in 2010 and 2017. Document analysis and individual and group interviews with managers (32) and employees (22) were carried out; the analysis draws on Auschra’s classification of barriers and facilitators of integration. Results The regions (pop. 130.000-169.000) comprise a larger town, a specialised hospital and several rural municipalities. The integration of children’s and young people’s services is based on organisational changes, in which the services from primary healthcare, hospitals, social work and schools (pupils’ and students’ healthcare) were merged into one organisation. The health and well-being centres were created by bringing mental health, substance abuse services and social services into health centre facilities, but under their own managers. In both cases, the experiences are mostly positive but the success of implementation varies; commitment and cooperation between managers, shared goals and mutual understanding of each other’s work as well as the planning process were crucial factors to support implementation. Conclusions Comprehensive organisations with unified management foster integration. The implementation of multiprofessional work is facilitated by organisational culture and collaboration between managers.