It is widely argued in policy circles and academic research that the health and social care needs of people with multiple and complex needs are greatly enhanced through a shared commitment to inter-professional practice and transformational learning. We take this assumption to task by examining a ‘community of practice’ (a working group for high-impact users facilitated by a large inner-city GP surgery), which brings together frontline practitioners and statutory commissioners working at the interface between homelessness, health and substance use. We then go on to identify four areas: (1) knowledge exchange and critical reflection; (2) networks of intervention; (3) inequality in relations and resources and (4) competition and congruence – that demand critical attention if we are to understand more fully the potential role of ‘communities of practice’ in acting as bridgeheads to health and social care integration.
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