Abstract

Objective: The Gateshead care home vanguard is a complex programme, combining service realignment, a new care pathway, formation of a provider alliance network, outcome based commissioning and a workforce development strategy. The aim of this study was to to establish a clear understanding of the programme as it was developing and the underlying assumptions and expectations about how it will produce change, in the local context.

Methods and results: We conducted semi- structured interviews (n=30) in February and March 2016, with senior decision-makers in the Gateshead Vanguard team and partner organisations; national decision-makers in NHS England; key members of the local health economy, including care home managers, GPs and nurse leaders. Topics included the main enablers, barriers, contextual factors necessary for successful development and implementation of the programme; how success should be judged, and the appropriateness of national evaluation metrics to the local context. Interviews were recorded, transcribed and subject to thematic analysis. These data were supplemented by a content analysis of documents produced by the care home vanguard and NHS England, and a stakeholder workshop. Findings will be presented at the ILPN conference.

Policy implications: This work will provide insights into the size and nature of the challenge faced by innovators in the complex, mixed economy of care homes. It will also identify policy priority questions to address in any evaluation of the developing care home vanguard programme.