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Implementing new care models: learning from the Greater Manchester demonstrator pilot experience

Elvey, Rebecca, Bailey, Simon, Checkland, Kath, McBride, Anne, Parkin, Stephen, Rothwell, Katy (2018) Implementing new care models: learning from the Greater Manchester demonstrator pilot experience. BMC Family Practice, 19 (89). E-ISSN 1471-2296. (doi:10.1186/s12875-018-0773-y)

Abstract

Background: Current health policy focuses on improving accessibility, increasing integration and shifting resources from hospitals to community and primary care. Initiatives aimed at achieving these policy aims have supported the implementation of various ‘new models of care’, including general practice offering ‘additional availability’ appointments during evenings and at weekends. In Greater Manchester, six ‘demonstrator sites’ were funded: four sites delivered additional availability appointments, other services included case management and rapid response. The aim of this paper is to explore the factors influencing the implementation of services within a programme designed to improve access to primary care. The paper consists of a qualitative process evaluation undertaken within provider organisations, including general practices, hospitals and care homes. Methods: Semi-structured interviews, with the data subjected to thematic analysis. Results: Ninety-one people participated in interviews. Six key factors were identified as important for the establishment and running of the demonstrators: information technology; information governance; workforce and organisational development; communications and engagement; supporting infrastructure; federations and alliances. These factors brought to light challenges in the attempt to provide new or modify existing services. Underpinning all factors was the issue of trust; there was consensus amongst our participants that trusting relationships, particularly between general practices, were vital for collaboration. It was also crucial that general practices trusted in the integrity of anyone external who was to work with the practice, particularly if they were to access data on the practice computer system. A dialogical approach was required, which enabled staff to see themselves as active rather than passive participants. Conclusions: The research highlights various challenges presented by the context within which extended access is implemented. Trust was the fundamental underlying issue; there was consensus amongst participants that trusting relationships were vital for effective collaboration in primary care.

Item Type: Article
DOI/Identification number: 10.1186/s12875-018-0773-y
Uncontrolled keywords: General practice, Qualitative research, Primary health care, Health services evaluation, Organizational innovation, Access to health care
Subjects: H Social Sciences
Divisions: Faculties > Social Sciences > School of Social Policy Sociology and Social Research > Centre for Health Services Studies
Depositing User: Simon Bailey
Date Deposited: 14 Nov 2018 11:45 UTC
Last Modified: 26 Sep 2019 09:14 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/70081 (The current URI for this page, for reference purposes)
Bailey, Simon: https://orcid.org/0000-0001-9142-2791
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