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

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 & social care in the community, 29 (4). pp. 1061-1071. ISSN 1365-2524

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Abstract / Description

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. [Abstract copyright: © 2020 The Authors. Health and Social Care in the Community published by John Wiley & Sons Ltd.]

Item Type:	Article
Additional Information:	** From PubMed via Jisc Publications Router
Uncontrolled Keywords:	dementia; commissioning; integrated care; mixed methods; practitioner perspectives; pragmatism; third sector
Subjects:	300 Social sciences > 360 Social problems & services; associations 600 Technology > 610 Medicine & health
Department:	School of Social Sciences and Professions
SWORD Depositor:	Pub Router
Depositing User:	Pub Router
Date Deposited:	11 Sep 2020 14:08
Last Modified:	20 Jul 2021 11:47
URI:	https://repository.londonmet.ac.uk/id/eprint/6025

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