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Integrating primary care and social services for older adults with multimorbidity: a qualitative study

Integrating primary care and social services for older adults with multimorbidity: a qualitative study
Integrating primary care and social services for older adults with multimorbidity: a qualitative study
BACKGROUND: Growing demand from an increasingly ageing population with multimorbidity has resulted in complex health and social care needs requiring more integrated services. Integrating primary care with social services could utilise resources more efficiently, and improve experiences for patients, their families, and carers. There is limited evidence on progress including key barriers to and drivers of integration to inform large-scale national change.
AIM: To elicit stakeholder views on drivers and barriers of integrated primary care and social services, and highlight opportunities for successful implementation.
DESIGN AND SETTING: A qualitative interview study.
METHOD: Semi-structured interviews with maximum variation sampling to capture stakeholder views across services and professions.
RESULTS: Thirty-seven interviews were conducted across England with people including GPs, nurses, social care staff, commissioners, local government officials, voluntary and private sector workers, patients, and carers. Drivers of integration included groups of like-minded individuals supported by good leadership, expanded interface roles to bridge gaps between systems, and co-location of services. Barriers included structural and interdisciplinary tension between professions, organisational self-interest, and challenges in record sharing.
CONCLUSION: Drivers and barriers to integration identified in other contexts are also present in primary care and social services. Benefits of integration are unlikely to be realised if these are not addressed in the design and execution of new initiatives. Efforts should go beyond local- and professional-level change to include wider systems- and policy-level initiatives. This will support a more systems-wide approach to integrated care reform, which is necessary to meet the complex and growing needs of an ageing multimorbid population.
Aged, Humans, Multimorbidity, Primary Health Care, Qualitative Research, Social Support, Social Work
0960-1643
e753-e761
Dambha-Miller, Hajira
58961db5-31aa-460e-9394-08590c4b7ba1
Simpson, Glenn
802b50d9-aa00-4cca-9eaf-238385f8481c
Hobson, Lucy
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Olaniyan, Doyinsola
c414cfd6-3482-414a-a6f1-b9627d9faadd
Hodgson, Sam
bc059529-009b-4f80-94b7-d5211a175eee
Roderick, Paul
dbb3cd11-4c51-4844-982b-0eb30ad5085a
Fraser, Simon DS
cda9a739-eedc-47e5-9dd7-17dda85349ee
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Everitt, Hazel
80b9452f-9632-45a8-b017-ceeeee6971ef
Santer, Miriam
3ce7e832-31eb-4d27-9876-3a1cd7f381dc
Dambha-Miller, Hajira
58961db5-31aa-460e-9394-08590c4b7ba1
Simpson, Glenn
802b50d9-aa00-4cca-9eaf-238385f8481c
Hobson, Lucy
7343b281-6e17-4f8a-a465-6bc88d0728a7
Olaniyan, Doyinsola
c414cfd6-3482-414a-a6f1-b9627d9faadd
Hodgson, Sam
bc059529-009b-4f80-94b7-d5211a175eee
Roderick, Paul
dbb3cd11-4c51-4844-982b-0eb30ad5085a
Fraser, Simon DS
cda9a739-eedc-47e5-9dd7-17dda85349ee
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Everitt, Hazel
80b9452f-9632-45a8-b017-ceeeee6971ef
Santer, Miriam
3ce7e832-31eb-4d27-9876-3a1cd7f381dc

Dambha-Miller, Hajira, Simpson, Glenn, Hobson, Lucy, Olaniyan, Doyinsola, Hodgson, Sam, Roderick, Paul, Fraser, Simon DS, Little, Paul, Everitt, Hazel and Santer, Miriam (2021) Integrating primary care and social services for older adults with multimorbidity: a qualitative study. The British journal of general practice : the journal of the Royal College of General Practitioners, 71 (711), e753-e761. (doi:10.3399/BJGP.2020.1100).

Record type: Article

Abstract

BACKGROUND: Growing demand from an increasingly ageing population with multimorbidity has resulted in complex health and social care needs requiring more integrated services. Integrating primary care with social services could utilise resources more efficiently, and improve experiences for patients, their families, and carers. There is limited evidence on progress including key barriers to and drivers of integration to inform large-scale national change.
AIM: To elicit stakeholder views on drivers and barriers of integrated primary care and social services, and highlight opportunities for successful implementation.
DESIGN AND SETTING: A qualitative interview study.
METHOD: Semi-structured interviews with maximum variation sampling to capture stakeholder views across services and professions.
RESULTS: Thirty-seven interviews were conducted across England with people including GPs, nurses, social care staff, commissioners, local government officials, voluntary and private sector workers, patients, and carers. Drivers of integration included groups of like-minded individuals supported by good leadership, expanded interface roles to bridge gaps between systems, and co-location of services. Barriers included structural and interdisciplinary tension between professions, organisational self-interest, and challenges in record sharing.
CONCLUSION: Drivers and barriers to integration identified in other contexts are also present in primary care and social services. Benefits of integration are unlikely to be realised if these are not addressed in the design and execution of new initiatives. Efforts should go beyond local- and professional-level change to include wider systems- and policy-level initiatives. This will support a more systems-wide approach to integrated care reform, which is necessary to meet the complex and growing needs of an ageing multimorbid population.

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Accepted/In Press date: 9 May 2021
e-pub ahead of print date: 30 September 2021
Published date: October 2021
Additional Information: Funding Information: The Southampton Primary Care Research Centre is a member of the National Institute for Health Research (NIHR) School for Primary Care Research (SPCR) and supported by NIHR research funds. Hajira Dambha-Miller is an NIHR Clinical Lecturer and received an NIHR SPCR grant for this work: SPCR2014-10043. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR, or the Department of Health and Social Care. Publisher Copyright: © 2021 Royal College of General Practitioners. All rights reserved. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
Keywords: Aged, Humans, Multimorbidity, Primary Health Care, Qualitative Research, Social Support, Social Work

Identifiers

Local EPrints ID: 453859
URI: http://eprints.soton.ac.uk/id/eprint/453859
ISSN: 0960-1643
PURE UUID: 2de3fcbe-401d-43f4-8f3f-cebb0b4deec6
ORCID for Hajira Dambha-Miller: ORCID iD orcid.org/0000-0003-0175-443X
ORCID for Glenn Simpson: ORCID iD orcid.org/0000-0002-1753-942X
ORCID for Paul Roderick: ORCID iD orcid.org/0000-0001-9475-6850
ORCID for Hazel Everitt: ORCID iD orcid.org/0000-0001-7362-8403
ORCID for Miriam Santer: ORCID iD orcid.org/0000-0001-7264-5260

Catalogue record

Date deposited: 25 Jan 2022 17:40
Last modified: 28 Apr 2022 02:30

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Contributors

Author: Glenn Simpson ORCID iD
Author: Lucy Hobson
Author: Doyinsola Olaniyan
Author: Sam Hodgson
Author: Paul Roderick ORCID iD
Author: Simon DS Fraser
Author: Paul Little
Author: Hazel Everitt ORCID iD
Author: Miriam Santer ORCID iD

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