Focus-group study maps managers’ barriers to integrated care

Participants identified trust, clear structures, governance and organisational continuity as important conditions for sustained collaboration and individual participation when coordinating services for adults with complex needs. The research, reported in BMC Health Services Research, explores managers’ experiences rather than measuring patient outcomes or testing an organisational intervention. The study used a descriptive qualitative design and three focus-group interviews with 13 participants.

The researchers analysed the interviews through qualitative content analysis. The topic was integrated healthcare and social services for adults with long-term mental, cognitive and physical conditions, a population described in the study as carrying a substantial disease burden. Co-occurring mental-health problems, substance use and social vulnerabilities further underscore the complex requirements placed on coordinated services.

Because the design relies on managers’ accounts, its findings concern experiences of collaboration and participation rather than the clinical effectiveness of integrated care. Qualitative analysis produced three categories: organisational prerequisites for the sustainable improvement of integrated care; prerequisites for interprofessional collaboration in addressing individuals’ needs; and support for individual change through relational and needs-based approaches. Eight subcategories were identified within these categories.

They also described awareness of and ambition for individualised, interprofessional and person-centred services, while reporting that these intentions did not always become established in day-to-day practice. Relational, structural and contextual factors shaped interprofessional collaboration in the managers’ accounts. The findings suggest that trust, clarified structures and governance, and organisational continuity may help address the distance between stated goals and implementation.

The study has a limited scope. Nevertheless, the analysis provides a focused account of the organisational and relational conditions that managers linked to sustainable collaboration. Its authors conclude that strengthening trust, clarifying structures and governance, and supporting continuity may enhance efforts to sustain integrated care and individual participation for adults with complex needs.

Subject of Research: Managers’ experiences of collaboration and individual participation in integrated healthcare and social services for adults with complex needs

Article Title: Managers’ experiences of collaboration and individual participation in integrated healthcare and social services for adults with complex needs: a focus group study

Article References: Hjelm, M., Plessen, V., Andersson, A., & Harris, U. (2026). Managers’ experiences of collaboration and individual participation in integrated healthcare and social services for adults with complex needs: a focus group study. BMC Health Services Research, 26(1), Article 1273. https://doi.org/10.1186/s12913-026-15602-y

Image Credits: AI Generated

DOI: 10.1186/s12913-026-15602-y

Keywords: integrated care, complex health needs, focus groups, qualitative research, interprofessional collaboration, person-centred care, service governance, organisational continuity, individual participation, healthcare managers, Managers, experiences