The purpose of the evaluation is to determine the impact and effectiveness of each Integrated Neighbourhood Team (INT) Multi -Disciplinary Team (MDT) in order to develop a best practice core model with the ability to reflect Socio-Economic and other population differences. The evaluation focusses on the different approaches between neighbourhoods in Pennine Lancashire and an analysis of the best elements to allow a joint, holistic service model to be developed.
To understand the different approaches to INTs taken by each of the neighbourhoods across Pennine Lancashire To understand how the staff implementing these view the approaches.
This project is based on a qualitative approach using 10 semi-structured interviews (of which 8 have been undertaken at this stage) and analysed using thematic grounded analysis. Qualitative research makes an important contribution to our understanding of health and healthcare. Semi-structured interviews allow participants the freedom to express their views in their own terms and provide reliable, comparable qualitative data. A further element involved a limited literature review on the use of multi-disciplinary teams within healthcare in the community, including the use of case management for multi-morbid complex patients.
The neighbourhoods across each CCG have their own methods of identifying patients for an MDT process and referral into the INT. Each neighbourhood has an MDT with a variety of participants, at which patients are discussed for a limited time . All of the care coordinators agree that there is very little awareness of case management and how it should be implemented across the workforce and there is a need for further training. The involvement of patients and carers differs across each neighbourhood, dependent on the influence and background of the coordinator. The care coordinators believe that patient care has improved as a result of the INT process, and feel that they are making a difference to those on the INT caseload. Further thematic analysis will need to be Undertaken.
The coordinators across both CCGs would appreciate a more standard approach whilst allowing for flexibility. Guidance should be produced to ensure the SOP is consistent and is implemented consistently across the neighbourhoods. INTs have had an impact on communication, but in the view of the coordinators not on the ways of working within individual services. Case management needs to be implemented as business as usual to increase the effectiveness of the INTs and the MDT approach. Further evaluation needs to be undertaken on whether the various approaches across each neighbourhood is meeting the needs of the populations or is increasing or maintaining health inequalities.