TY - JOUR T1 - Integration of care: the salvation of the NHS? JF - Future Hospital Journal JO - Future Hosp J SP - 77 LP - 78 DO - 10.7861/futurehosp.2-2-77 VL - 2 IS - 2 AU - Paul F Jenkins Y1 - 2015/06/01 UR - http://www.rcpjournals.org/content/2/2/77.abstract N2 - The performance of the NHS continues to be a focus for national media attention and concern regarding its welfare was the first priority of the public in pre-election polls. Although the scientific rigour of national targets as arbiters of efficiency and quality in healthcare provision is open to question, there is little debate that hospitals are struggling to cope with the demand placed upon them and that the quality of care they deliver can fall below acceptable standards. Is the NHS failing, manifesting declining performance as it slides steadily into frail old age, or is the explanation more complex? More importantly, are there potential opportunities for rejuvenating our largest public institution?Factors contributing to poor NHS performance have been catalogued many times. People are living longer and developing increasingly complex medical and social problems. A younger population is presenting prematurely with medical conditions fostered by the alarming prevalence of obesity and the influence of adverse lifestyle factors, including alcohol, tobacco and other drug usage. Our patients and their families have higher expectations of the health service, attributable partly to advances in medical technology and the publicity that surrounds it, and partly through promises made by politicians, particularly in the run up to general elections. Moreover, in recent decades we have witnessed a changing social structure in which family support is no longer the backbone of care delivery for aged relatives while, at the same time, investment in community support services has declined. These observations suggest that, rather than tired old age being responsible for declining performance, the NHS has a consistent historical record … ER -