A typology of integrated care policies in the care home sector: a policy document analysis

Simpson, G., Entwistle, C., Short, A. D., Morciano, M. and Stokes, J. (2023) A typology of integrated care policies in the care home sector: a policy document analysis. Frontiers in Public Health, 11, 943351. (doi: 10.3389/fpubh.2023.943351) (PMID:36895695) (PMCID:PMC9989008)

Abstract

Background: Health and social care systems in many countries have begun to trial and adopt “integrated” approaches. Yet, the significant role care homes play within the health and social care system is often understated. A key first step to identifying the care home integration interventions that are most (cost-)effective is the ability to precisely identify and record what has been implemented, where, and when—a “policy map.” Methods: To address gaps relating to the identification and recording of (cost-)effective integrated care home interventions, we developed a new typology tool. We conducted a policy mapping exercise in a devolved region of England—Greater Manchester (GM). Specifically, we carried out systematic policy documentary searches and extracted a range of qualitative data relating to integrated health and social care initiatives in the GM region for care homes. The data were then classified according to existing national ambitions for England as well as a generic health systems framework to illustrate gaps in existing recording tools and to iteratively develop a novel approach. Results: A combined total of 124 policy documents were identified and screened, in which 131 specific care home integration initiatives were identified. Current initiatives emphasized monitoring quality in care homes, workforce training, and service delivery changes (such as multi-disciplinary teams). There was comparatively little emphasis on financing or other incentive changes to stimulate provider behavior for the care home setting. We present a novel typology for capturing and comparing care home integration policy initiatives, largely conceptualizing which part of the system or specific transition point the care home integration is targeting, or whether there is a broader cross-cutting system intervention being enacted, such as digital or financial interventions. Conclusions: Our typology builds on the gaps in current frameworks, including previous lack of specificity to care homes and lack of adaptability to new and evolving initiatives internationally. It could provide a useful tool for policymakers to identify gaps in the implementation of initiatives within their own areas, while also allowing researchers to evaluate what works most effectively and efficiently in future research based on a comprehensive policy map.

• Item Type: Articles
• Additional Information: This study was funded by the National Institute for Health and Care Research (NIHR) [NIHR201872] and supported by the NIHR Applied Research Collaboration Greater Manchester [NIHR200174]. The views expressed in this publication are those of the authors and not necessarily those of the National Institute for Health and Care Research or the Department of Health and Social Care. JS was supported by an MRC fellowship (MR/T027517/1).
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Stokes, Dr Jonathan
• Authors: Simpson, G., Entwistle, C., Short, A. D., Morciano, M., and Stokes, J.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU
• Journal Name: Frontiers in Public Health
• Publisher: Frontiers Media
• ISSN: 2296-2565
• ISSN (Online): 2296-2565
• Copyright Holders: Copyright © 2023 Simpson, Entwistle, Short, Morciano and Stokes
• First Published: First published in Frontiers in Public Health 11: 943351
• Publisher Policy: Reproduced under a Creative Commons License