Cross-sector Service Provision in Health and Social Care: An Umbrella Review.
BACKGROUND
Meeting the complex health needs of people often requires interaction among numerous different sectors. No one service can adequately respond to the diverse care needs of consumers. Providers working more effectively together is frequently touted as the solution. Cross-sector service provision is defined as independent, yet interconnected sectors working together to better meet the needs of consumers and improve the quality and effectiveness of service provision. Cross-sector service provision is expected, yet much remains unknown about how it is conceptualised or its impact on health status. This umbrella review aims to clarify the critical attributes that shape cross-sector service provision by presenting the current state of the literature and building on the findings of the 2004 review by Sloper.


METHODS
Literature related to cross-sector service provision is immense, which poses a challenge for decision makers wishing to make evidence-informed decisions. An umbrella review was conducted to articulate the overall state of cross-sector service provision literature and examine the evidence to allow for the discovery of consistencies and discrepancies across the published knowledge base.


RESULTS
Sixteen reviews met the inclusion criteria. Seven themes emerged: Focusing on the consumer, developing a shared vision of care, leadership involvement, service provision across the boundaries, adequately resourcing the arrangement, developing novel arrangements or aligning with existing relationships, and strengthening connections between sectors. Future research from a cross-organisational, rather than individual provider, perspective is needed to better understand what shapes cross-sector service provision at the boundaries.


CONCLUSIONS
Findings aligned closely with the work done by Sloper and raise red flags related to reinventing what is already known. Future researchers should look to explore novel areas rather than looking into areas that have been explored at length. Evaluations of out-comes related to cross-sector service provision are still needed before any claims about effectiveness can be made.
Health and Rehabilitation Sciences, Faculty of Health Sciences, Western University, London, ON, Canada; George and Fay Yee Centre for Healthcare Innovation Evaluation Platform, Winnipeg Regional Health Authority and The University of Manitoba, Winnipeg, MB, Canada.
Shannon
S
Winters
Health and Rehabilitation Sciences, Faculty of Health Sciences, Western University, London, ON, Canada.
Lilian
L
Magalhaes
Health and Rehabilitation Sciences, Faculty of Health Sciences, Western University, London, ON, Canada; Centre for Education Research and Innovation, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.
Elizabeth
E
Anne Kinsella
Health and Rehabilitation Sciences, Faculty of Health Sciences, Western University, London, ON, Canada.
Anita
A
Kothari
cross-sector collaboration; health care; partnership; service provision; social care