Goodman, Claire, Drennan, Vari, Davies, Sue, Masey, Helen, Gage, Heather, Scott, Cherill, Manthorpe, Jill, Brearley, Sally and Iliffe, Steve (2010) Nurses as case managers in primary care: the contribution to chronic disease management. Report for the National Institute for Health Research Service Delivery and Organisation programme. Project Report. National Institute for Health Research Evaluations, Trials and Studies Coordinating Centre (NETSCC) / Queen's Printer and Controller of HMSO, Southampton, UK.

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Abstract

[Scientific Summary] Government policy has suggested that nurses play a greater role than before in the health service response to people with long term conditions (LTC) and in particular in assuming the case management role. This is attributable to increasing numbers of people requiring sustained and co-ordinated care for their LTC, an environment of changing health and social care labour markets, an increasing diversity of health and social care provision and greater patient/user choice. This study is designed to inform those engaged in decision making for service organisation and delivery. It will enable them to determine the extent and impact of NMHV working as case managers within different models of care delivery on patients and service utilisation and its place within complex health and social care networks. Specifically the study objectives are: - Identify the drivers that have stimulated the development of models of chronic disease management that involve NMHV and map their development over time.- Describe the range and type of chronic disease models and the ways that they involve service users and carers. - Describe and classify the roles and responsibilities of NMHVs in current models of chronic disease management.- Evaluate the impact of NMHVs contribution to the experiences of patients, service users, professionals and carers.- Identify the factors that enable NMHVs to contribute most effectively to successful outcomes of care- Identify the factors that sustain the models of care over time.- Describe the mechanisms that are used for knowledge transfer and enhance learning between all members of the care team and the wider organisation.- Evaluate the impact of the NMHV contribution upon the cost, quality, effectiveness and organisation of the care provided.The study is designed in two phases with phase one informing the case selection within phase two.Phase one:1. National overview (macro level analysis): Review of policy and research on NMHV contribution to LTC.2. Service Organisation and implementation (meso level analysis) A scoping exercise of key informants from up to 100 NHS trusts and Local Health Boards across England and Wales to survey and establish how the nursing contribution to long term care has been interpreted and implemented. The combined findings from phase one addresses objectives 1,2,3,4,5,8 informs the framework for phase two and will provide a classification of different models of care delivery that involves nursing, their origins, sustainability, evidence base and how they have been implemented across England and Wales. Phase two:3. User experience and outcomes (micro level analysis): Drawing on the principles of realist evaluation and using an in depth comparative case study design we will study prospectively over 9 months the patient experience (n=20) and nursing contribution (n=12) within four different models of care delivery for LTC that are provided in three separate Trusts. We will address objectives 4, 5, 6, 7, 8.by comparing and contrasting the experience of the people with LTC, the factors that support and inhibit the nurses taking case management roles and the cost consequences of different models for the patients and the health and social care services. The policy and research review combined with the evaluation of four different models of care delivery in three different settings will give service commissioners, providers, practitioners and users evidence as a basis for decision making about the nursing contribution as they improve and reshape services for people with long term conditions.

Item Type:	Monograph (Project Report)
Additional Information:	[1] HS&DR Project - 08/1605/122. [2] This project was commissioned by the NIHR Service Delivery and Organisation (NIHR SDO) programme under the management of the National Coordinating Centre for the Service Delivery and Organisation (NCCSDO) which was based at the London School of Hygiene and Tropical Medicine (LSHTM). The project was managed by NCCSDO until 31 March 2009. Management of the NIHR Service Delivery and Organisation (SDO) programme and its portfolio of projects transferred to the National Institute for Health Research Evaluations, Trials and Studies Coordinating Centre (NETSCC) based at the University of Southampton from 1 April 2009. The final report resulting from this project was reviewed and published by NETSCC. [3] This project was originally commissioned as "Evaluating the nursing, midwifery and health visiting contribution to models of chronic disease management" and the title change was approved as a result of the editorial review process.
Uncontrolled Keywords:	nursing, midwifery, health visiting, chronic disease management, long term condition, social care labour market, social care, care manager
Subjects:	R Medicine > RA Public aspects of medicine R Medicine > RT Nursing
Pre-2014 Departments:	School of Health & Social Care
Related URLs:	Publisher Organisation Organisation
Last Modified:	14 Oct 2016 09:14
URI:	http://gala.gre.ac.uk/id/eprint/5611

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