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

Journal article


Mike Chase, Lloyd, C., Benjamin J. Peters, Elaine Chase and Kellyn Lee 2020. Joining the dots: Day to day challenges for practitioners in delivering integrated dementia care. Health & Social Care in the Community. https://doi.org/10.1111/hsc.13140
AuthorsMike Chase, Lloyd, C., Benjamin J. Peters, Elaine Chase and Kellyn Lee
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.

Keywordscommissioning; Dementia; Integrated care; mixed methods; practitioner perspectives; pragmatism; third sector
Year2020
JournalHealth & Social Care in the Community
PublisherWiley Online Library
ISSN09660410
1365-2524
Digital Object Identifier (DOI)https://doi.org/10.1111/hsc.13140
Web address (URL)https://doi.org/10.1111/hsc.13140
https://www.scopus.com/record/display.uri?eid=2-s2.0-85089530215&origin=resultslist&sort=plf-f&src=s&sid=bd63cf4f3f8fe0606230e26aae70933f&sot=b&sdt=b&s=TITLE-ABS-KEY%28Joining+the+dots%3A+Day+to+day+challenges+for+practitioners+in+delivering+integrated+dementia+care%29&sl=142&sessionSearchId=bd63cf4f3f8fe0606230e26aae70933f
Output statusPublished
Publication dates
Online18 Aug 2020
18 Jul 2021
Publication process dates
Accepted22 Jul 2020
Deposited15 Jun 2023
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