Chase, M;
Lloyd, CEM;
Peters, BJ;
Chase, E;
Lee, K;
(2020)
Joining the dots: Day to day challenges for practitioners in delivering integrated dementia care.
Health and Social Care in the Community
10.1111/hsc.13140.
(In press).
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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.
| Type: | Article |
|---|---|
| Title: | Joining the dots: Day to day challenges for practitioners in delivering integrated dementia care |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1111/hsc.13140 |
| Publisher version: | https://doi.org/10.1111/hsc.13140 |
| Language: | English |
| Additional information: | This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0/ |
| Keywords: | commissioning, Dementia, integrated care, mixed methods, practitioner perspectives, pragmatism, third sector |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Education UCL > Provost and Vice Provost Offices > School of Education > UCL Institute of Education UCL > Provost and Vice Provost Offices > School of Education > UCL Institute of Education > IOE - Education, Practice and Society |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10109946 |
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