Abstract
Background
Dementia care is a key priority for both NHS England and the UK Government. National guidelines highlight the importance of care coordination to address the challenges people living with dementia and their carers can encounter when trying to access the health and care system. To counter these challenges, Kent and Medway Integrated Care Board (ICB) have recently implemented a proactive Dementia Care Coordinator (DCC) service to support people with dementia and their carers from pre diagnosis to end of life care.
Aim
To understand how the DCC service works, (or not) for whom and in what circumstances. The findings will inform service development and future investment decisions.
Design and setting
This study uses a realist approach to evaluate the DCC service in Kent and Medway ICB, south-east England, population 1.9 million, comprising 42 Primary Care Networks (groups of general practices) each having a DCC.
Methods
An initial programme theory will be developed from existing literature, and in collaboration with stakeholders. Mixed methods including questionnaires to DCCs; service provider metrics; and qualitative interviews will be used to collect data on service provider and service user experiences. Interpretive comparative analysis and narrative synthesis including evaluation of service costs against outcomes will produce a refined final programme theory.
Results
Results from this project will produce evidence-based recommendations to help improve service delivery and possible service expansion.
Conclusion
This protocol describes a realist evaluation designed to investigate the recently implemented DCC service in Kent and Medway ICB.
How this fits in
Dementia services in primary care are undergoing a period of transformation. In Kent and Medway, a recent implemented service has been that of the dementia care coordinator, a proactive role to help people living with dementia and carers navigate the care system. Yet challenges exist when implementing a new role and new service into existing primary care organisation. This realist evaluation will explore what works, for whom, how, why and under what circumstances. Findings will provide evidence capable of informing future decisions about the DCC service including how the service can be successfully improved and expanded where appropriate.