Longing for Integrated Care: The Importance of Effective Governance

Last March I had the honour to do my inaugural lecture at the University of Tilburg/TIAS Business School, where I have held since 2016 my chair called ‘Innovation of the organization and governance of integrated care’ [1]. For me it was a day to remember. In the Netherlands it is also a very formal and traditional ceremony where family, friends, colleagues and other relations are invited to share this moment. The inaugural lecture and the related book were a perfect reason for me to take some time for reflection on how to bring integrated care further and what challenges there are for a research agenda. This editorial is a pleasant invitation to share some of my ideas with the readers of our Journal. My lecture was called ‘Longing for Integrated Care’ or in Dutch ‘Verlangen naar Integraliteit’. Of course this title was chosen for a reason. When I reflect on where we are in our way towards integrated care worldwide, I see that more and more clients, professionals and policy makers are looking in the direction of integrated care as a perspective; a perspective to reduce fragmentation because the real needs of people are often not really being seen and served. What really matters for a person like Mrs Van der Munt and her family, an 84 year old lady, living alone at home, becoming more and more fragile and heavily relying on her daughter to keep the promise that she can stay and die in her own home? What is the real issue in diabetes care? (Self) managing blood sugar levels? Or is it managing having diabetes in your social life, your cooking habits and daily living? Integrated care starts with a holistic perspective on what matters to people; otherwise the real essence of integrated care can be missed [1]. Integrated care is not about creating a multidisciplinary offer/supply, but it is about creating an integrative answer to the most important issues of people in need. A holistic approach seems logical, but it means a lot for how we organise our (health)care and welfare systems, and the needed connections with other domains in life [2]. Also, it asks for effective collaboration between professionals, clients and organizations. That also means a mis-fit with traditional governance which is mostly focusing on expanding or maintaining organizations or is professionally driven. Accountability is mostly targeted at ‘those who pay and those who can punish’ like health care insurers, policy makers and health care inspectorates. I expect that the era in which being mostly accountable towards clients, the community and the society will be on the rise.