Relationships, expertise, incentives, and governance: supporting care home residents' access to health care: an interview study from England
Objectives To explore what commissioners of care, regulators, providers, and care home residents in England identify as the key mechanisms or components of different service delivery models that support the provision of National Health Service (NHS) provision to independent care homes. Methods...
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| Format: | Article |
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Elsevier
2015
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| Online Access: | https://eprints.nottingham.ac.uk/40859/ |
| _version_ | 1848796148975796224 |
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| author | Goodman, Claire Davies, Sue L. Gordon, Adam L. Meyer, Julienne Dening, Tom Gladman, John R.F. Iliffe, Steve Zubair, Maria Bowman, Clive Victor, Christina Martin, Finbarr C. |
| author_facet | Goodman, Claire Davies, Sue L. Gordon, Adam L. Meyer, Julienne Dening, Tom Gladman, John R.F. Iliffe, Steve Zubair, Maria Bowman, Clive Victor, Christina Martin, Finbarr C. |
| author_sort | Goodman, Claire |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | Objectives
To explore what commissioners of care, regulators, providers, and care home residents in England identify as the key mechanisms or components of different service delivery models that support the provision of National Health Service (NHS) provision to independent care homes.
Methods
Qualitative, semistructured interviews with a purposive sample of people with direct experience of commissioning, providing, and regulating health care provision in care homes and care home residents. Data from interviews were augmented by a secondary analysis of previous interviews with care home residents on their personal experience of and priorities for access to health care. Analysis was framed by the assumptions of realist evaluation and drew on the constant comparative method to identify key themes about what is required to achieve quality health care provision to care homes and resident health.
Results
Participants identified 3 overlapping approaches to the provision of NHS that they believed supported access to health care for older people in care homes: (1) Investment in relational working that fostered continuity and shared learning between visiting NHS staff and care home staff, (2) the provision of age-appropriate clinical services, and (3) governance arrangements that used contractual and financial incentives to specify a minimum service that care homes should receive.
Conclusion
The 3 approaches, and how they were typified as working, provide a rich picture of the stakeholder perspectives and the underlying assumptions about how service delivery models should work with care homes. The findings inform how evidence on effective working in care homes will be interrogated to identify how different approaches, or specifically key elements of those approaches, achieve different health-related outcomes in different situations for residents and associated health and social care organizations. |
| first_indexed | 2025-11-14T19:43:23Z |
| format | Article |
| id | nottingham-40859 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| last_indexed | 2025-11-14T19:43:23Z |
| publishDate | 2015 |
| publisher | Elsevier |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-408592020-05-04T17:05:19Z https://eprints.nottingham.ac.uk/40859/ Relationships, expertise, incentives, and governance: supporting care home residents' access to health care: an interview study from England Goodman, Claire Davies, Sue L. Gordon, Adam L. Meyer, Julienne Dening, Tom Gladman, John R.F. Iliffe, Steve Zubair, Maria Bowman, Clive Victor, Christina Martin, Finbarr C. Objectives To explore what commissioners of care, regulators, providers, and care home residents in England identify as the key mechanisms or components of different service delivery models that support the provision of National Health Service (NHS) provision to independent care homes. Methods Qualitative, semistructured interviews with a purposive sample of people with direct experience of commissioning, providing, and regulating health care provision in care homes and care home residents. Data from interviews were augmented by a secondary analysis of previous interviews with care home residents on their personal experience of and priorities for access to health care. Analysis was framed by the assumptions of realist evaluation and drew on the constant comparative method to identify key themes about what is required to achieve quality health care provision to care homes and resident health. Results Participants identified 3 overlapping approaches to the provision of NHS that they believed supported access to health care for older people in care homes: (1) Investment in relational working that fostered continuity and shared learning between visiting NHS staff and care home staff, (2) the provision of age-appropriate clinical services, and (3) governance arrangements that used contractual and financial incentives to specify a minimum service that care homes should receive. Conclusion The 3 approaches, and how they were typified as working, provide a rich picture of the stakeholder perspectives and the underlying assumptions about how service delivery models should work with care homes. The findings inform how evidence on effective working in care homes will be interrogated to identify how different approaches, or specifically key elements of those approaches, achieve different health-related outcomes in different situations for residents and associated health and social care organizations. Elsevier 2015-05-01 Article PeerReviewed Goodman, Claire, Davies, Sue L., Gordon, Adam L., Meyer, Julienne, Dening, Tom, Gladman, John R.F., Iliffe, Steve, Zubair, Maria, Bowman, Clive, Victor, Christina and Martin, Finbarr C. (2015) Relationships, expertise, incentives, and governance: supporting care home residents' access to health care: an interview study from England. Journal of the American Medical Directors Association, 16 (5). pp. 427-432. ISSN 1538-9375 Care homes older people health services frailty health care realist review http://www.sciencedirect.com/science/article/pii/S1525861015000730 doi:10.1016/j.jamda.2015.01.072 doi:10.1016/j.jamda.2015.01.072 |
| spellingShingle | Care homes older people health services frailty health care realist review Goodman, Claire Davies, Sue L. Gordon, Adam L. Meyer, Julienne Dening, Tom Gladman, John R.F. Iliffe, Steve Zubair, Maria Bowman, Clive Victor, Christina Martin, Finbarr C. Relationships, expertise, incentives, and governance: supporting care home residents' access to health care: an interview study from England |
| title | Relationships, expertise, incentives, and governance: supporting care home residents' access to health care: an interview study from England |
| title_full | Relationships, expertise, incentives, and governance: supporting care home residents' access to health care: an interview study from England |
| title_fullStr | Relationships, expertise, incentives, and governance: supporting care home residents' access to health care: an interview study from England |
| title_full_unstemmed | Relationships, expertise, incentives, and governance: supporting care home residents' access to health care: an interview study from England |
| title_short | Relationships, expertise, incentives, and governance: supporting care home residents' access to health care: an interview study from England |
| title_sort | relationships, expertise, incentives, and governance: supporting care home residents' access to health care: an interview study from england |
| topic | Care homes older people health services frailty health care realist review |
| url | https://eprints.nottingham.ac.uk/40859/ https://eprints.nottingham.ac.uk/40859/ https://eprints.nottingham.ac.uk/40859/ |