With ever increasing demands on the health and social care system, both politicians and technocrats have championed integration between the two sectors as a major element to meet this challenge. Even though verbal and explicit opposition to this policy is scarce, successful and sustainable integration efforts do not tend to be readily observable and wide-spread. The main objective of the goal-directed research in this article is to uncover to what extent social psychological processes play a role in this seeming “disconnect” between what people “say” and what they actually “do.” A total of 63 (n = 63) participants volunteered to partake in the study. The results indicate that healthcare participants indicate higher levels of social empathy, social perspective taking, and willingness to reach out and share resources as compared with those in social care during the explicit studies. Yet, the implicit data suggest a moderate to strong automatic bias which may well hinder integration efforts. We provide a way forward to increase the validity of these methods and provide recommendations for policy within health and social care integration in England. In addition, these recommendations have wider application to areas concerned with organizational change such as; mergers, acquisitions, and other collaborative working arrangements.

How does one go about asking for opinions from participants about ‘health and social care integration’? As this ‘concept of integration’ is relatively vague and ambiguous. Indeed, in an earlier project we found that people that work in the social care sector really favoured closer collaboration, whereas healthcare colleagues really did not care much about such collaboration. This impression is merely anecdotal in nature, how does one tease out an individual’s preference for collaboration. In short, we have decided to use the empathy scale from the well- established Social Dominance Orientation scales, to use as a proxy for ‘willingness to collaborate’. Essentially, the assumption made here is; if a participant indicates a higher level of empathy then they are more likely to collaborate with others. It follows from this assumption that those more likely to collaborate are more like to want to integrate. It is this logic that has been applied to the creation of this experiment and we anticipate that this will be a contentious point. We would like to point out that, even though on its own, this may be a precarious assumption to make. However, this experimental study should be seen in light of the wider dissertation and the wider study design context in which it operates.

The study outlined in this paper, was designed to elicit in-group and out-group bias between self-grouped and self-categorised participants, is an adaptation of Tajfel's (et al) 1979 study on ‘social comparison and group interest in in-group favouritism’. Therefore, their article, and others related to it, will be extensively quoted and used in this paper as they form the basis of this study. The Tajfel study examined the effects of reward magnitude and comparability of the out-group on minimal inter-group discrimination where self-interest was related to in-group profit. Favouritism towards own group is hypothesised to arise from inter-group comparison to enhance self-esteem as well as instrumental rivalry for group and self-interest. In this adaptation of their study, sixty-three participants, which were employed in the health sector (n=31) and in the social care sector (n=32) in the North East of England were requested (as part of their survey completion) to distribute rewards (fictitious funding/monetary) via amended choice matrices, to the in-group and the relevant comparison out-group. Self-interest was explicitly and directly linked to the allocation of absolute profit to the in-group.

For all the literature that is available in social psychology, few are dedicated to the process of social status attribution. However, such a process may have significant impact on the way groups of people interact. With very limited amount of actual published literature directly related to this cognitive process, the quest to find a study that could measure (to some degree) the underlying process of status attribution was even more constrained. Having searched the literature extensively, we could not identify any publications that were specific in the current prevalent theory was derived. As a result, we have designed a study which utilises both a quantitative interactive method and a qualitative method in rapid succession. First, we requested participants to complete a ranking exercise where ten (10) job titles needed to be ranked in order from 1 (highest) to 10 (lowest). This is followed by a open-ended question; “Can you talk me through that last exercise, why did you rank people in the way that you did?” This paper will briefly outline relevant literature and the process of designing this study, before it will analyse the results of the study. Findings suggest that status beliefs could be cultivated even in the absence of such interactional context. Using the abstraction of job-roles (which represent social categories) we demonstrated that status beliefs emerge in both Healthcare (HC) and social care (SC) participants of this study and these tend to indicate and confirm strongly held explicit and implicit beliefs about social status.

England, Switzerland and the Netherlands each provide near-universal healthcare coverage and achieve broadly comparable outcomes, yet they have resolved the central question of market versus planning in markedly different ways. England operates a tax-financed national service that intensified provider competition in 2012 and formally reversed course towards statutory integration in 2022. Switzerland operates a mandatory-insurance system under the KVG and LAMal, with competition among insurers set within a cantonally federalised regulatory structure shaped by direct democracy. The Netherlands operates the fullest European implementation of regulated managed competition, following its 2006 Health Insurance Act. This paper reviews the conceptual, empirical and methodological literature bearing on the comparison of these three systems. It finds a mature body of typological theory, an extensive descriptive benchmarking literature, and a well-developed and self-critical methodological canon, but almost no work that brings these together. Specifically, there appears to be no theory-driven, explanatory, genuinely mixed-methods comparison of this particular triad. Comparison of the three countries is overwhelmingly either descriptive country profiling, wide-panel benchmarking in which the three appear as members of a larger sample, or single-country evaluation. Five gaps are identified and ranked by novelty and feasibility. The most significant is the absence of explanatory comparison linking institutional design to outcomes through stakeholder-informed qualitative evidence. A second concerns the near-total absence of comparison of the three roughly contemporaneous reforms now under way: the Swiss EFAS financing reform approved by referendum in November 2024, the Dutch Integraal Zorgakkoord and its passende zorg framework from 2022, and England’s 2022 Health and Care Act and 2025 NHS Ten Year Health Plan. Candidate research questions and a proposed explanatory sequential design, with an optional sub-national configurational component, are set out for discussion.

Background: With the SARS-CoV-2 pandemic gripping most of the globe, healthcare and economic recovery strategies are being explored currently as a matter of urgency. The underpinning rationale of this paper is that we believe that health and care services are provided locally, therefore, local implications of national policy need to be reflected when informing national responses to the SARS-CoV-2 pandemic. Methods: We adopted the assumptions underlying the United Kingdom government’s national epidemiological model which influences the national policy response to the SARS-CoV-2 pandemic. We used these in a local context and show projections in terms of presentations of symptomatic patients differ in a variety of settings. Setting: North of England, United Kingdom, population modelled at four local constituent levels which aggregated gives a total population of 3.2m . Results: We clearly demonstrate that there is significant difference in the way the national modelling outputs are replicated at local levels. Specifically, in terms of projected increased levels of demand for services on the local health and care systems. Conclusions: We present significant evidence of differing timelines specifically in terms of subsequent projected peak demands. Additionally, it clearly indicates varying levels of such demand throughout the four modelled localities. These idiosyncrasies are ‘masked’ by both regional and national approaches to modelling. We urge readers to ensure that any national policy is appropriately adopted through the use of complementary bottom up approach, to suit local health and care systems. Finally, we share our methodology to ensure other professionals could replicate this study elsewhere.