Integrating care in Singapore – The role of an enabling agency

Introduction: Efforts at integration usually focus on either top down policies implemented over a specific region or the local interventional initiatives. This paper discusses how an intermediate enabling agency can support care integration at multiple levels. Aims: This paper describes the advantage derived from deploying an intermediate enabling agency to support the integration of care within regions as well as across horizontal sectors. Results: The Agency for Integrated Care was (AIC) formed in 2009 as an independent entity at “arms length” away from both policy making and service provision, to catalyse and support regional and sectoral efforts in the integration of care delivery. AIC has helped foster integration at multiple levels, including the systemic, organizational, professional, clinical, normative and functional fronts, and nurtured the implementation of new care delivery models. This integration has occurred across traditional boundaries such as healthcare, social care and community mental health services, as well as, to varying degrees, across public, private and voluntary welfare sectors. Despite the rapidly changing environment, AIC has supported rapid adoption of horizontal and vertical care integration and capacity and capability building initiatives.