Engaging General Practitioners in Service Development and Quality Improvement in Care Homes

Project: Research

Project Details


Research question
How, when and under what circumstances does GP involvement in service development, implementation and improvement in care homes result in effective implementation or improved outcomes for residents?
425,000 older people live in UK care homes. Their healthcare is complex due to multiple health conditions, prominent cognitive impairment and physical dependency. There is growing evidence that healthcare to the sector delivers better outcomes if NHS staff have protected time and space to develop relational working with care home staff, if they have expertise in dementia care, and if services are organised around the care home. The recent Optimal (NIHR HS+DR) and PEACH (Dunhill Medical Trust) studies identified an important role for general practitioners in successful service development and quality improvement (QI) in the sector, mediated in part by their role as primary healthcare providers and in part by their role as gatekeepers for healthcare. Both studies reported examples where poor GP engagement limited progress with service development or QI.
To understand the role which GPs have been demonstrated to play, as part of a wider multidisciplinary team, in development, implementation and improvement of healthcare in care homes, in order to shape recommendations about when they need to be involved, and how to get them involved, in QI in the sector.
Using realist synthesis (RS), develop a programme theory which describes the types of outcomes for which GP involvement is required for service development, delivery and improvement in care homes, and the mechanisms by which GP involvement helps realise the outcomes. To describe contextual factors influencing GP engagement with service development, delivery and improvement for healthcare interventions in care homes.
Effective start/end date1/06/1931/08/20


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