Dementia care coordinators in primary care: a realist evaluation

Area of Science:

• Gerontology
• Health Services Research
• Public Health

Background:

• A new dementia care coordinator (DCC) service has been implemented in Kent and Medway Integrated Care Board (ICB).
• DCCs operate at the primary care network (PCN) level, supporting GP practices.
• The service aims to improve navigation and provide proactive support for dementia service users.

Purpose of the Study:

• To understand the operational mechanisms of the DCC service, including target populations and circumstances of use.
• To identify the outcomes, resource implications, and costs associated with the DCC service.

Main Methods:

• A mixed-methods realist evaluation with an embedded economic component was employed.
• Data collection involved questionnaires, service provider metrics, and qualitative interviews with practitioners and service users.
• Interpretive comparative analysis, narrative synthesis, and cost-outcome evaluation were used to refine the programme theory.

Main Results:

• Healthcare practitioners, including GPs, welcomed DCC integration into local practices.
• DCCs effectively connect service users to care pathways, potentially increasing diagnosis rates and reducing crises.
• Current caseloads are unmanaged, leading to workforce over-stretching and potential service strain.

Conclusions:

• Preliminary findings from the Kent and Medway DCC service evaluation are presented.
• There is a critical need for enhanced support for the DCC workforce to ensure service sustainability.
• The evaluation results will guide future service development and investment decisions.