Research Uncovers Key Challenges in Health and Social Care Regional Integration Fund

Business News Wales

22-05-2025

Research led by the University of South Wales (USW) has identified issues at the heart of the Welsh Government's £146 million Health and Social Care Regional Integration Fund (RIF).
RIF is a five-year funding programme with the aim to establish and mainstream six new national models of integrated care to achieve the vision of 'A Healthier Wales: the Welsh Government's long-term plan for Health and Social Care'.
Delivering integrated care, where organisations and care professionals are aligned, is essential to improving outcomes for people who use health and social care services.
The RIF is a key lever for change and transformation across the health and social care. Its priority population groups include older people (including people with dementia), children and young people with complex needs, people with learning disabilities and neurodevelopmental conditions, unpaid carers, and people with emotional and mental health wellbeing needs.
The Welsh Institute of Health and Social Care (WIHSC), based at USW, was awarded a contract of more than £1 million to lead an evaluation of the RIF. The three-year programme of work is a collaboration between USW, Brunel University London, OB3 Research, Swansea University, and the Royal College of Surgeons Ireland.
Published by Welsh Government, the first report of the study (From theory to practice) highlights six key issues that it says need to be addressed and brought into balance if RIF is to achieve its aims: Alignment and Aspiration: The RIF is designed to meet specific policy goals, but it also aims to achieve broader, more ambitious changes in creating seamless services.
The RIF is designed to meet specific policy goals, but it also aims to achieve broader, more ambitious changes in creating seamless services. Control and Collaboration: The balance between central control and the need for teamwork and shared decision-making can shift over time, creating power dynamics that need to be managed.
The balance between central control and the need for teamwork and shared decision-making can shift over time, creating power dynamics that need to be managed. Fidelity and Flexibility: There's tension between sticking to the RIF's guidelines and giving local teams the flexibility they need to adapt to real-world challenges.
There's tension between sticking to the RIF's guidelines and giving local teams the flexibility they need to adapt to real-world challenges. Accountability and Autonomy: While there's a need for clear accountability and spending of public money, there's also a desire for more independence in how decisions are made, and actions are taken.
While there's a need for clear accountability and spending of public money, there's also a desire for more independence in how decisions are made, and actions are taken. Ownership and Partnership: It's not always clear who is ultimately responsible for the Fund's work, and questions remain about how much true partnership is involved in delivering its goals.
It's not always clear who is ultimately responsible for the Fund's work, and questions remain about how much true partnership is involved in delivering its goals. Structure and Agency: The RIF aims to transform existing systems, but it operates within current organizational structures, which can make achieving meaningful change more complicated.
Professor Mark Llewellyn, Director of WIHSC, said:
'In addition to the points above, we have also put forward 11 'areas for further consideration', which are questions around working together, data collection, reporting and resourcing, and the development of new models of care.
'The health and care systems in Wales, as is the case across the UK, are facing acute resource pressures. The RIF is trying to change a system in real time, a system under significant strain and stress. Project development across the regions is seeing innovative approaches to deliver care and support services during the transitional year from the Integrated Care Fund and Transformation Fund to the RIF.
'However, this presents a unique opportunity to rethink how health and social care can work together more effectively. By addressing these tensions and fostering true collaboration, we have the potential to create a more integrated system that delivers better outcomes for the people who need it most through the development of integrated models of care.'