Implementing new care models: learning from the Greater Manchester demonstrator pilot experience

Area of Science:

• Health Services Research
• Primary Care Management
• Health Policy Implementation

Background:

• Current health policy emphasizes improved accessibility, integration, and resource shifts to community and primary care.
• New models of care, such as extended hours in general practice, are being implemented to meet policy aims.
• Six demonstrator sites in Greater Manchester explored additional availability, case management, and rapid response services.

Purpose of the Study:

• To explore factors influencing the implementation of new primary care services.
• To understand challenges in delivering extended access appointments and other community-based services.
• To evaluate the process of implementing new care models within provider organizations.

Main Methods:

• Qualitative process evaluation conducted within provider organizations.
• Semi-structured interviews with 91 participants.
• Thematic analysis of interview data.

Main Results:

• Six key factors identified: IT, information governance, workforce development, communications, infrastructure, and alliances.
• Challenges were encountered in providing new or modifying existing services.
• Trust was a fundamental underlying issue, vital for collaboration, especially between general practices and external entities accessing data.

Conclusions:

• Extended access implementation faces contextual challenges.
• Trusting relationships are fundamental for effective collaboration in primary care.
• A dialogical approach is needed to empower staff as active participants in service changes.