Care coordination: translating policy into practice for older people

Abstract

Purpose -The authors aim to present findings from their research on the implementation of Unified Assessment (UA) policy and the work of care coordinators who oversee the delivery of support to older people with complex needs. Design/methodology/approach -A mixed methods approach included staff interviews (n ¼ 95) and focus groups (n ¼ 3). Findings -The care coordinator role is controversial and the lack of common terminology across health and social care obscures its importance. It is seen as a social care responsibility. Limited ownership amongst healthcare professionals leads to tensions in practice. The challenges of breaking down silo thinking embedded in established professional practices are highlighted as are infrastructural and capacity deficits. Disparities between policy intentions and practice means that UA is failing to meet core objectives relating to the delivery of seamless support. Research limitations/implications -Further research is needed to develop and evaluate evidenceinformed interventions that test solutions to the problems faced in practice and support the delivery of more effective arrangements. Practical implications -Practice development may be supported by: guidelines that are more prescriptive and include a formal role definition; joint training to promote shared understanding of key concepts; investment in administrative and IT infrastructures; and more coordinated direction at strategic level. Originality/value -Over a decade has elapsed since the publication of UA Policy Guidance; however, there is limited published evidence on the effectiveness of UA policy and its translation into practice.

A Multilevel Framework for Complex Care: A Critical Interpretive Synthesis

“…To achieve this aim, care coordinators facilitate communication and collaboration in the development and implementation of complex care plans that involve multiple providers, services, and sectors. Te scope of care coordination initiatives varied: care coordination was used to address transitions in care [41,42], to enhance primary care [28,30], and to span the continuum of care across ongoing, integrated, or intersectoral treatment [43,44].…”