The 25th International Conference on Integrated Care wasn’t just a milestone, it was a moment of collective reflection. A quarter century on from the early days of integrated care, what have we achieved? What have we learned? And, perhaps most importantly, what is holding us back?
IFIC has galvanised a diverse and passionate community around the principles of integrated care. There are real examples of success; communities and systems that have managed to overcome fragmentation and deliver care in more coordinated, person-centred ways.
Yet, in too many places, care remains siloed. Scaling integrated care beyond pilots and pockets of excellence is still the exception rather than the rule. Too often, promising programmes falter; undone by system churn, short-term funding, or the loss of a few key champions. The persistent challenge of evaluating impact—both meaningfully and economically—remains a barrier. Even when evaluations are attempted, they are frequently under-resourced, retrospective, or disconnected from decision-making. There is growing awareness that we need to do things differently.
Health systems are complex and dynamic. To embed integrated care meaningfully, we need solutions that are as adaptive and evolving as the systems they serve. Learning health systems offer promise, yet there is still a chasm between evidence and everyday practice.
Getting knowledge into practice
Several presentations at this year’s conference explored how HealthPathways may be helping to bridge that gap. Dr. Kieran Holland introduced HealthPathways as a unique international collaborative, enabling frontline care teams to co-design and maintain locally relevant, evidence-informed pathways. Crucially, HealthPathways functions as the procedural memory of a learning health system, helping systems retain and improve local knowledge even as policies, personnel, and politics shift.
Examples of HealthPathways scaling across five countries; now covering over 30 million people; suggest a different trajectory is possible.
Dr. Alastair Roeves shared the striking progress of NHS Wales, where in just over a year nearly 300 national pathways have been developed for local adaptation. With more than a million pathway views and growing, a recent Ministerial Advisory Group report singles out care pathways as a key lever for improving system performance.
From Canada, Dr. Reham Abdelhalim and Heather Shaw shared how Ontario Health Teams are preparing to launch HealthPathways in 2025, setting the stage for wider adoption across the country.
Meanwhile, Prof. Nick Goodwin and Dr. Holland offered a timely look at the economics: their scoping review identified 28 studies evaluating integrated care pathways, a much-needed contribution as the fiscal environment demands more rigorous demonstration of value.
Dr. David Hambleton’s workshop on scaling care pathways drew a lively and engaged international audience. The message was clear: collaboration across borders is no longer optional; it is essential. We must stop reinventing wheels and start building on what already works, together.
The future of the integrated care movement
As the Streamliners team left the conference, one question lingered: What would it take to finally move from integrated care as a “promising innovation” to a standard expectation in every health system? IFIC’s next chapter must focus on scale, sustainability, and systems change. We already have many of the tools. What we need now is the collective will to apply them consistently, strategically, and at scale. That’s the real opportunity for Birmingham 2026: not just another conference, but a pivot point. A chance to move from proof-of-concept to proof-of-impact.
Dr. Kieran Holland
Streamliners NZ
Kieran is Clinical Director of Research at Streamliners and supports evaluation across the global HealthPathways Community. After training in medicine Kieran developed an interest in health system improvement through working on a range of initiatives during the transformation of the Canterbury health system.