Patients’ experiences of a multidisciplinary team-led community case management programme: a qualitative study

Abstract

ObjectivesTo explore the views and experiences of patients on the care they have received while enrolled on the Northumberland High Risk Patient Programme (NHRPP). This programme involved case finding of frail patients using a multidisciplinary team (MDT)-led community case management programme, and support of patients through care planning and regular reviews using primary, community, secondary and social care professionals.DesignA qualitative study using semistructured interviews, which were digitally recorded, transcribed and subject to thematic analysis.SettingCommunity patients receiving primary care in the county of Northumberland, England.Participants23 participants took part, of which 16 were patients enrolled on the NHRPP, and 7 carers. GP practices were selected purposively by size, deprivation and location, and patients identified and invited by General Practitioners to participate.Results4 main themes emerged from the data: awareness and understanding of the NHRPP, confidence in the primary healthcare team, limitations of home care and the active role of being a patient. Despite having a low level of awareness of the details of the NHRPP, participants did think that its broad aim made sense. Participants discussed their high level of satisfaction with their care and access to team members. However, some limitations of alternatives to hospital care were identified, including the need to consider psychological as well as medical needs, the importance of overnight care and the needs of those without informal carers. Finally, participants discussed the active nature of being a patient under the NHRPP if they were to contribute fully to planning and managing their own care.ConclusionsThis study has identified that a programme of MDT-led case management was generally very well received by patients and their families. However, a number of factors were identified that could improve the implementation of the programme and further research needs to be undertaken to address these.

Experiences of case management with chronic illnesses: a qualitative systematic review

“…; Gowing et al. ). ‘The trouble with that was they [case managers] came to put you to bed at six o'clock at night’, said one patient of Gowing et al.…”

“…Four studies pointed out that patients and caregivers felt better informed about their conditions and their disease (Gowing et al. ; Sandberg et al. ; Sheaff et al.…”

“…Participants, especially caregivers, also explained that they got advice from their case managers about the importance of self‐care (Gowing et al. ).…”

“…‘The trouble with that was they [case managers] came to put you to bed at six o'clock at night’, said one patient of Gowing et al. (). ‘I know why, they had to get around a lot of people’ (p. 4).…”

“…; Gowing et al. ; Sandberg et al. ), but some studies included relatively young patients who were under 50 years old (Passey et al.…”