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Joining the dots:: day to day challenges for practitioners in delivering integrated dementia care

Joining the dots:: day to day challenges for practitioners in delivering integrated dementia care
Joining the dots:: day to day challenges for practitioners in delivering integrated dementia care
Despite the increasing policy focus on integrated dementia care in the UK, little is known about the opportunities and challenges encountered by practitioners charged with implementing these policies on the ground. We undertook an extensive, mixed‐methods analysis of how a contemporary multidisciplinary dementia pathway in the UK was experienced and negotiated by service providers. Our pragmatic mixed methods design incorporated three types of research interaction with practitioners: (a) Semi‐structured interviews (n = 31) and focus group discussions (n = 4), (b) Practitioner ‘shadowing’ observations (n = 19), and (c) Service attendance and performance metrics reviews (n = 8). Through an abductive analysis of practitioner narratives and practice observations, we evidenced how inter‐practitioner prejudices, restrictive and competitive commissioning frameworks, barriers to effective data sharing and other resource constraints, all challenged integrative dementia care and led to unintended consequences such as practice overlap and failure to identify and respond to people's needs. In order to more successfully realise integrated dementia pathways, we propose innovative commissioning frameworks which purposefully seek to diffuse power imbalances, encourage inter‐provider respect and understanding, and determine clear lines of responsibility.
Dementia, commissioning, integrated care, mixed methods, practitioner perspectives, pragmatism, third sector
0966-0410
Chase, Mike
3fef7b88-4d26-4630-8147-8faf0770a125
Lloyd, Christopher E.M.
64c59b9f-2819-4342-8f93-febcfd16eb34
Peters, Benjamin J.
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Chase, Elaine
ca8ad48c-8b9e-4700-9c35-efa5fe71e2c8
Lee, Kellyn
6c8c3a3e-f987-4ca0-b1a6-466afeeb399c
Chase, Mike
3fef7b88-4d26-4630-8147-8faf0770a125
Lloyd, Christopher E.M.
64c59b9f-2819-4342-8f93-febcfd16eb34
Peters, Benjamin J.
98774e14-514f-4432-8716-d799ae0d6487
Chase, Elaine
ca8ad48c-8b9e-4700-9c35-efa5fe71e2c8
Lee, Kellyn
6c8c3a3e-f987-4ca0-b1a6-466afeeb399c

Chase, Mike, Lloyd, Christopher E.M., Peters, Benjamin J., Chase, Elaine and Lee, Kellyn (2020) Joining the dots:: day to day challenges for practitioners in delivering integrated dementia care. Health and Social Care in the Community. (doi:10.1111/hsc.13140).

Record type: Article

Abstract

Despite the increasing policy focus on integrated dementia care in the UK, little is known about the opportunities and challenges encountered by practitioners charged with implementing these policies on the ground. We undertook an extensive, mixed‐methods analysis of how a contemporary multidisciplinary dementia pathway in the UK was experienced and negotiated by service providers. Our pragmatic mixed methods design incorporated three types of research interaction with practitioners: (a) Semi‐structured interviews (n = 31) and focus group discussions (n = 4), (b) Practitioner ‘shadowing’ observations (n = 19), and (c) Service attendance and performance metrics reviews (n = 8). Through an abductive analysis of practitioner narratives and practice observations, we evidenced how inter‐practitioner prejudices, restrictive and competitive commissioning frameworks, barriers to effective data sharing and other resource constraints, all challenged integrative dementia care and led to unintended consequences such as practice overlap and failure to identify and respond to people's needs. In order to more successfully realise integrated dementia pathways, we propose innovative commissioning frameworks which purposefully seek to diffuse power imbalances, encourage inter‐provider respect and understanding, and determine clear lines of responsibility.

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More information

Accepted/In Press date: 21 July 2020
e-pub ahead of print date: 18 August 2020
Additional Information: Publisher Copyright: © 2020 John Wiley & Sons Ltd
Keywords: Dementia, commissioning, integrated care, mixed methods, practitioner perspectives, pragmatism, third sector

Identifiers

Local EPrints ID: 443564
URI: http://eprints.soton.ac.uk/id/eprint/443564
ISSN: 0966-0410
PURE UUID: 703e3b6b-0bda-4dcb-bb35-110e2f69a6cc

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Date deposited: 01 Sep 2020 16:32
Last modified: 17 Oct 2022 17:34

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Contributors

Author: Mike Chase
Author: Christopher E.M. Lloyd
Author: Benjamin J. Peters
Author: Elaine Chase
Author: Kellyn Lee

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