Authors' objectives: It is often the case that older people with multiple health problems are admitted to hospital, sometimes again and again. These are referred to as unplanned admissions . But there is an opportunity to organise care better before people need to go to hospital. This can be a win-win - people can continue daily life in their communities and the NHS can reduce waiting-time pressures and costs on hospital services. These 'integrated care' services can reduce unnecessary admissions by partly replacing hospital care with non-hospital care. Some research already exists about how integrated care services can work. Now the NHS is planning to introduce new 'models of care' to improve the coordination of hospital and non-hospital services. Among the new models are 'Multi-Specialty Community Providers' (MCPs). In MCPs, general practices will provide a wider range of services than now, including perhaps some outpatient services now provided at hospitals. MCPs are new, so there isn t any research about them yet. However, what we will do in this study is use research about other related types of integrated care to discover how to design and operate these new MCPs. Our research will have four parts. We will: 1. Produce an overview of current MCP-type care in the UK and internationally. 2. Compare this overview with the proposed MCPs in the NHS. 3. Explore the effects of these MCPs and investigate how these effects are achieved in different settings or health systems. 4. In discussion with our stakeholder group, propose how MCPs could be organised and funded in the NHS. Methods We will use three main research methods, in the following order: 1. We will try to set out clearly the policy-makers' reasons for setting up MCPs, what effects they expect MCPs to have, and how they expect MCPs to produce these effects. 2. From these rationale, and from existing research about integrated care, we will devise a strategy for searching relevant databases of research studies and for collecting the findings into groups. 3. Lastly we will compare what these research studies have found with the policy-makers' rationale about MCPs. Depending on what the research studies say, we will then either spell out the policy makers' assumptions more fully, or say which conditions the assumptions apply to (and which not), or revise them to match the evidence. In this way we will produce 'logic models' that are better supported by existing research evidence, which can be used to guide the setting up of MCPs in the NHS. Projected outputs Besides scientific publications and a final report to HSDR, the main study output will be more strongly evidence-based 'logic models' to aid the formation and early operation of MCPs. To achieve this we will consult health workers (including GPs and NHS managers) to ensure that our findings are relevant and usable.

Project Status: Completed

URL for project: http://www.nets.nihr.ac.uk/projects/hsdr/157734

Year Published: 2018

URL for published report: https://www.journalslibrary.nihr.ac.uk/programmes/hsdr/157734/#/

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: England, United Kingdom

Organisation Name: NIHR Health Services and Delivery Research programme

Contact Address: NIHR Journals Library, National Institute for Health and Care Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK

Contact Name: journals.library@nihr.ac.uk

Contact Email: journals.library@nihr.ac.uk

Copyright: Queen's Printer and Controller of HMSO