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

Article


Chase, M., Lloyd, C. E. M., Peters, B. J., Chase, E. and Lee, K. 2020. Joining the dots: Day to day challenges for practitioners in delivering integrated dementia care. Health and Social Care in the Community. https://doi.org/10.1111/hsc.13140
AuthorsChase, M., Lloyd, C. E. M., Peters, B. J., Chase, E. and Lee, K.
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.

JournalHealth and Social Care in the Community
ISSN1365-2524
Year2020
PublisherJohn Wiley & Sons, Ltd.
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Anyone
Digital Object Identifier (DOI)https://doi.org/10.1111/hsc.13140
Publication dates
Online18 Aug 2020
Publication process dates
Accepted22 Jul 2020
Deposited08 Sep 2020
Copyright holder© 2020 The Authors
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