Early evidence of the development of primary care networks in England: a rapid evaluation study

Smith, Judith; Parkinson, Sarah; Harshfield, Amelia; Sidhu, Manbinder

doi:10.3310/hsdr-tr-129678

Cited by 14 publications

(38 citation statements)

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“…Attempting to simultaneously capture the various dynamics of inter organisational collaboration within one overarching theory is an enormously complex task. Indeed, one example alone cited having 47 different potential organisational forms (75). Nonetheless, these collaborative entities have more commonalities than differences when it comes to what in uences their functioning.…”

Section: Discussionmentioning

confidence: 99%

“…These small successes serve to rapidly bolster trust and can be increased further through factors such as seconding staff (71,72), and having open, honest, stable, and empathetic leadership (70,81). Alongside these quick wins are longer-term battles, such as the need to ensure effective interpersonal communication between key organisational actors, managing con ict (46,51,65,66), and either creating a new culture or helping build bridges between existing ones (30,39,75).…”

Section: Middle Stage Of Collaborationmentioning

confidence: 99%

“…Additionally, having a larger size and/or number of organisations involved can make communicating more di cult due to the increased number of involved actors and moving parts (50). IT system compatibility (45,75), joint appointments (66), and having regular collaboration-wide meetings can also work to increase trust as an outcome through the mechanism of interpersonal communication (44,60). When cultures are mismatched or not mutually understood, con ict can occur, which thereby reduces trust (71).…”

Section: Middle Stage Of Collaborationmentioning

confidence: 99%

“…However, these bene ts seldom come to fruition due to the sheer amount of work and goodwill that is required to rise above the quagmire of the daily functioning of the partnership, explaining why many collaborations are not successful. Studies capture contexts where "too much was being expected too soon… as they were still working out how to function operationally before they could accomplish goals such as decreasing workload and improving care" (75).…”

Section: Re Ning Cmocs Driving Partnership Performancementioning

confidence: 99%

“…Initial trust was put forward in phase 2 of our realist synthesis as likely to come into play in the 'Connecting' phase of collaboration, during which organisations seek partners and establish initial relationships. Contextual elements identi ed as essential to determining this initial level of trust are the history of collaborating or competing between the organisations (58,63,74,75), their organisational reputations (67), and at a later stage, the strength of legal agreements (69). These factors have been found to serve as glue where trust is lacking, or to simply act as an initial reassurance when relying on a partner (43,67).…”

Section: Mechanisms Speci C To Early Stages Of Collaborationmentioning

confidence: 99%

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When trust, confidence, and faith collide: refining a realist theory of how and why inter-organisational collaborations in healthcare work

Aunger

Millar

Greenhalgh

2021

Preprint

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Background Health systems are facing unprecedented socioeconomic pressures as well as responding to the ongoing strains and surges brought about by the Covid-19 pandemic. In response, the reconfiguration of health systems to encourage greater collaboration and integration has been promoted with a variety of collaborative shapes and forms being encouraged and developed. Despite this continued interest, evidence for success of these various arrangements is lacking with the links between collaboration and improved performance often remaining uncertain. To date, many examinations of collaborations have been undertaken, but use of realist methodology may shed additional light on how and why collaboration works, and whom it benefits. Methods This paper seeks to test initial context-mechanism-outcome configurations (CMOCs) of interorganisational collaboration with the view to producing a refined realist theory. This phase of the review used case study and evaluation literature; combined with supplementary systematic searches. These searches were screened for rigour and relevance, after which CMOCs were extracted from included literature and compared against existing ones for refinement, refutation, or affirmation. We also identified demi-regularities to better explain how these CMOCs were interlinked.Results Fifty-one papers were included, from which 338 CMOCs were identified, where many were nonunique. This resulted in new mechanisms such as ‘risk threshold’ and refinement of many others, including trust, confidence, and faith, into more well-defined constructs. Refinement and addition of CMOCs enabled the creation of a ‘web of causality’ depicting how contextual factors form CMOC chains which generate outputs of collaborative behaviour. Core characteristics of collaborations, such as whether they were mandated or cross-sector, were explored for their proposed impact according to the theory.Conclusion The formulation of this refined realist theory allows for greater understanding of how and why collaborations work and can serve to inform both future work in this area and the implementation of these arrangements. Future work should delve deeper into collaborative subtypes and the underlying drivers of collaborative performance.Review registration This review is part of a larger realist synthesis, registered at PROSPERO with ID CRD42019149009.

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Section: Discussionmentioning

confidence: 99%

Section: Middle Stage Of Collaborationmentioning

confidence: 99%

Section: Middle Stage Of Collaborationmentioning

confidence: 99%

Section: Re Ning Cmocs Driving Partnership Performancementioning

confidence: 99%

Section: Mechanisms Speci C To Early Stages Of Collaborationmentioning

confidence: 99%

See 3 more Smart Citations

When trust, confidence, and faith collide: refining a realist theory of how and why inter-organisational collaborations in healthcare work

Aunger

Millar

Greenhalgh

2021

Preprint

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Change starts with me: an impact evaluation of a multiprofessional leadership programme to support primary care networks in the South East of England

Jackson

Manley

Vibhuti

2021

LHS

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PurposeThis paper aims to present the impact evaluation findings from a multiprofessional leadership programme commissioned in the South East of England to support primary care networks (PCNs) to lead system improvement together. It identifies programme impact at micro and meso system levels; a leadership impact continuum that can be used by individuals and teams to evidence impact of improvements in PCN practices; the learning and development strategies that were effective and proposes implications for other networks. Design/methodology/approachMixed methods underpinned by practice development methodology were used to explore the impact of the programme on two practitioner cohorts across 16 PCNs. Data were collected at the start, mid-point and end of the eight-month programme. FindingsResults illustrate an innovative approach to collective leadership development. A continuum of impact created with participants offers insight into the journey of transformation, recognising that “change starts with me”. The impact framework identifies enablers, attributes and consequences for measuring and leading change at micro, meso and macro levels of the health-care system. Participants learned how to facilitate change and collaboratively solve problems through peer consulting which created a safe space for individuals to discuss workplace issues and receive multiprofessional views through action learning. These activities enabled teams to present innovative projects to commissioners for service redesign, enabling their PCN to be more effective in meeting population health needs. The authors believe that this programme may provide a model for other PCNs England and other place-based care systems internationally. Originality/valueThis study offers insight into how to enable a journey of transformation for individuals and PCN teams to enhance team effectiveness and collective leadership for system-wide transformation required by the National Health Service Long Term Plan (2019). Contribution to Impact

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The healthcare needs and general practice utilization of people with acquired neurological disability and complex needs: A scoping review

Oliver

Douglas

Winkler

et al. 2022

Health Expectations

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Background For people with acquired neurological disabilities and complex needs, general practitioners (GPs) play an important role in health management and early intervention for the prevention of comorbidities and health complications. People with disability are a vulnerable group who need and have the right to, quality general practice services. It is therefore important to understand the health needs and service use of this group. The aim of this review was to identify the healthcare needs and general practice utilization of people with acquired neurological disabilities and complex needs. Methods A scoping review methodological framework was utilized. Six databases (MEDLINE, PsycInfo, CINAHL, Scopus, Embase and the Cochrane Library) were searched. Articles were included if they reported on general practice service utilization of people with acquired neurological disabilities and complex needs aged between 18 and 65. Articles were required to be peer‐reviewed, written in English and published between 2010 and 2021. Results Thirty‐one articles were included in the review. Studies originated from Canada (9), the United States (8), Australia (4), Switzerland (4), the United Kingdom (2), England (1), Norway (1), France (1) and Denmark (1). For many people, GPs were the main healthcare provider. People with disability consult multiple healthcare providers and navigate complex healthcare systems. Commonly presented healthcare needs were bladder, bowel and skin problems, pain and chronic pain, medication needs and mental health concerns. Conclusions People with acquired neurological disabilities and complex needs were vulnerable to receiving suboptimal healthcare. The literature highlighted issues regarding the accessibility of services, the fragmentation of health services and inadequate preventative care. GPs were challenged to offer adequate disability‐related expertise and to meet the mental health needs of people with disability within time constraints. Patient and Public Involvement This manuscript was prepared in collaboration with a GP, who is one of the authors. A person with lived experience of acquired neurological disability was engaged to check the alignment of the findings with their personal experience and provide feedback.

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Early evidence of the development of primary care networks in England: a rapid evaluation study

Cited by 14 publications

References 0 publications

When trust, confidence, and faith collide: refining a realist theory of how and why inter-organisational collaborations in healthcare work

When trust, confidence, and faith collide: refining a realist theory of how and why inter-organisational collaborations in healthcare work

Change starts with me: an impact evaluation of a multiprofessional leadership programme to support primary care networks in the South East of England

The healthcare needs and general practice utilization of people with acquired neurological disability and complex needs: A scoping review

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