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All areas in England are expected by National Health Service (NHS) England to develop integrated care systems (ICSs) by April 2021. ICSs bring together primary, secondary and community health services, and involve local authorities and the voluntary sector. ICSs build on previous pilots, including the Integrated Care Pioneers in 25 areas from November 2013 to March 2018. This analysis tracks the Pioneers’ self-reported progress, and the facilitators and barriers to improve service coordination over three years, longer than previous evaluations in England. The paper aims to discuss these issues.

Annual online key informant (KI) surveys, 2016–2018, are used for this study.

By the fourth year of the programme (2017), KIs had shifted from reporting plans to implementation of a wide range of initiatives. In 2018, informants reported fewer “significant” barriers to change than previously. While some progress in achieving local integration objectives was evident, it was also clear that progress can take considerable time. In parallel, there appears to have been a move away from aspects of personalised care associated with user control, perhaps in part because the emphasis of national objectives has shifted towards establishing large-scale ICSs with a particular focus on organisational fragmentation within the NHS.

Because these are self-reports of changes, they cannot be objectively verified. Later stages of the evaluation will look at changes in outcomes and user experiences.

The current study shows clearly that the benefits of integrating health and social care are unlikely to be apparent for several years, and expectations of policy makers to see rapid improvements in care and outcomes are likely to be unrealistic.

Role-emerging placements have been used internationally within occupational therapy education but are relatively new to Ireland. At times, there has been a debate in the profession regarding the use of this placement model. This paper aims to generate views from both occupational therapists and occupational therapy students on the use of role-emerging placements in the Republic of Ireland.

Electronic surveys were administered to occupational therapy students and occupational therapists in Ireland. Quantitative data were analysed using the SPSS Statistics software package and the content of the open question responses were analysed into themes.

Occupational therapists (n = 60) and occupational therapy students (n = 45) indicated that there were inconsistent views surrounding role-emerging placements. It is deemed as an effective method for student learning, but apprehension exists around inclusion within occupational therapy programmes in the Republic of Ireland. Preference was indicated towards inclusion of role-emerging placements on a part-time basis within formal occupational therapy education.

Both respondent groups viewed that role-emerging placements can positively influence new areas of occupational therapy practice and concern over the use of the placement model requires further exploration and debate. This study is from an Irish context, although there are similarities with other countries’ use of the placement model. There is a need for research through an in-depth exploration of the learning experience of undertaking role-emerging placements from the students’ perspective and identification of supports required to promote an optimal learning experience.