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Can a case lead approach deliver the “craft and graft” of integration?

Di Bailey (Department of Social Sciences, Nottingham Trent University, Nottingham, UK)
Gabriella Jennifer Mutale (Notttingham Trent University, Nottingham, UK)

Journal of Integrated Care

ISSN: 1476-9018

Article publication date: 30 July 2020

Issue publication date: 5 February 2021

74

Abstract

Purpose

The aim of this study was to explore the experiences and outcomes for adults with complex needs over time, within and between two teams that delivered integrated care across different Councils' services. The teams' approach to integration included two key features: a “case lead” way of working and the team itself operating as a single point of access (SPA) for residents in given neighbourhoods with high deprivation.

Design/methodology/approach

The study was designed as evaluation research located in the realist tradition. Two teams acted as a case study to provide an in-depth understanding of how the case lead approach and SPA delivered the craft and graft of integrated working in the teams. Mixed methods of data collection included residents' ratings of their quality of life on five domains in an outcome measure over a six-month period. Residents and staff working in the teams also participated in semi-structured interviews to explore their respective experiences and receiving and delivering integrated care. The costs of care delivery incurred by residents were calculated based on their demands on public services in the year leading up to the teams' intervention and the projected costs for one year following this.

Findings

The relationship between team context, case leads' inputs and residents' outcomes was mediated through the managerial style in the integrated teams which enabled case leads to be creative and do things differently with residents. Case leads worked holistically to prevent residents being in crisis as well as giving practical help such as sorting debts and finances and supporting access to volunteering or further education. Residents rated their quality of life as significantly improved over a six-month period and significant savings in costs as result of the teams' support were projected.

Originality/value

The study used a multi-evaluation realistic evaluation methodology to explore the relationship between team context, case leads' inputs and residents' outcomes in terms that integrated services across different District and County Council Departments.

Keywords

Acknowledgements

The authors would like to acknowledge Ashfield District Council as the organisation that provided the funding for the evaluation.

Citation

Bailey, D. and Mutale, G.J. (2021), "Can a case lead approach deliver the “craft and graft” of integration?", Journal of Integrated Care, Vol. 29 No. 1, pp. 72-84. https://doi.org/10.1108/JICA-11-2019-0046

Publisher

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Emerald Publishing Limited

Copyright © 2020, Emerald Publishing Limited

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