Key messages: 

• Aligning different organisational cultures and professional practices was identified as a key workforce challenge. In integrated neighbourhood teams, staff come from various employers (NHS, local authority, voluntary sector) and each group has its own culture and protocols 

• Workforce rigidity and siloed roles had to be addressed. Traditional job descriptions often did not cover the cross-cutting nature of integrated care. Some local areas created new hybrid roles, such as ‘care navigator’ or ‘community link worker’ positions, that worked across health and social care. 

• Staffing shortages and retention presented a challenge, particularly in community and social care roles which often had high turnover.  

• Differing employment terms and management structures across organisations had to be navigated.  

• Joint training and continuous learning emerged as a crucial strategy. The briefing provides examples of integrated teams conducting regular multi-disciplinary training sessions. 
   

Policy implications: 

• Create frameworks for cross-sector workforce development: Policymakers and workforce planners should develop frameworks that allow health and social care staff to be recruited, trained, and deployed in a more unified way.  

• Invest in training for integrated care competencies: There is a need for formal training programs focusing on the skills needed in integrated settings, for example, interdisciplinary team communication, care coordination, and community engagement.  

• Support new role creation and career paths: To make integrated care a viable and attractive career direction, policy should recognise and legitimise new roles like care coordinators or community health workers 

• Facilitate secondments and joint appointments: Regulators and employers should be encouraged (through guidance or incentive funding) to use secondments or joint appointments as tools for integration.  

• Promote inclusive, community-reflective hiring: To advance equity, policies could encourage integrated teams to hire staff who reflect the demographics of the communities they serve (including language skills, cultural competence, etc.).  

Commentary:  

The focus on workforce in neighbourhood integration is a reminder that systems are made of people, and if we don’t equip and inspire those people to work differently, integration remains an ideal rather than a reality. This briefing brings to life the often underappreciated ‘human infrastructure’ of integrated care. From an equity and care quality perspective, a well-integrated workforce means people experience seamless care. For example, consider an older adult with complex needs: in a siloed system, they may see a district nurse, a social worker, and a charity volunteer separately, each with fragmented information. In a well-integrated team, those workers collaborate daily, so the patient experiences them as one coherent support system. That only happens if the team on the ground has been enabled and encouraged to truly work together. 

This study highlights the importance of breaking down professional silos. Historically, different professions not only had separate employers but also distinct identities, “I’m an NHS nurse” vs “I’m a social care officer”, each perhaps unfamiliar with the other’s expertise. Integration efforts show that when these professionals start to understand and trust each other, care improves. But getting there requires time and policy support. It’s essentially a cultural change project. For equity, this matters because siloed care often fails those with multiple needs (who are often among the most vulnerable). If a person’s housing, mental health, and medical needs are tackled by an integrated team, they’re far more likely to see improvement than if each issue is dealt with in isolation. 

However, it’s evident that staff need the tools (joint IT systems), the environment (shared spaces), and the incentives (recognition, career growth) to make integration their daily mode of operation. This briefing shows encouraging solutions, e.g., joint training and new roles, which policymakers should note. It also implies that failing to address workforce issues can doom integration: if staff remain on incompatible systems or under crushing workloads due to vacancies, even the best structural plan will falter. 

In the context of care equity, having a workforce that is engaged in the community is key. Integrated neighbourhood teams can build deeper relationships with local residents, understand social contexts, and tailor interventions (like scheduling appointments at times convenient for working carers, or doing home visits jointly). A stable, well-supported team is more likely to innovate in these equity-focused ways. Conversely, high turnover or disjointed teams might stick to business-as-usual, which could perpetuate gaps in care for hard-to-reach groups. 

In summary, this evidence reinforces a simple truth: integrated care is delivered by integrated teams. Building those teams is as critical as any policy blueprint. For decision-makers, it means that alongside restructuring services, equal attention must be paid to human resource policies, training, and staff well-being in integrated models. It’s an investment not just in better jobs for the workforce, but in better and fairer care for the community.