Lessons learnt from the implementation of new care models in the NHS: a qualitative study of the North East Vanguards programme

Objective To examine lessons learnt from the implementation of five Vanguard initiatives in the North East of England.Design Data collection comprised semistructured interviews with key informants at each site.Setting The study took place across six local authority areas in the North East of England...

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Main Authors: David J Hunter, Gregory Maniatopoulos, Jonathan Erskine, Bob Hudson
Format: Article
Language:English
Published: BMJ Publishing Group 2019-11-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/9/11/e032107.full
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author David J Hunter
Gregory Maniatopoulos
Jonathan Erskine
Bob Hudson
author_facet David J Hunter
Gregory Maniatopoulos
Jonathan Erskine
Bob Hudson
author_sort David J Hunter
collection DOAJ
description Objective To examine lessons learnt from the implementation of five Vanguard initiatives in the North East of England.Design Data collection comprised semistructured interviews with key informants at each site.Setting The study took place across six local authority areas in the North East of England and within six clinical commissioning groups responsible for the delivery of each Vanguard’s aims and objectives.Participants Sixty-six interviewees with participants from five Vanguard initiatives in the North East of England, including senior clinicians, project leads and directors, commissioners, and healthcare managers.Results While the context for each Vanguard is separate and distinct, there also exists a set of common issues which have a regional dimension. Participants felt that the national programme helped to raise the profile of local change initiatives and also contributed to the wider understanding of regional service integration issues. At the same time our findings demonstrate that all five sites experienced, and were subject to, unrealistic pressure placed on them to deliver outcomes. Of particular concern among all sites was the sheer scale and pace of change occurring at the same time as the National Health Service was being tasked with making significant, if unrealistic, efficiency savings.Conclusions It is too early to conclude with any confidence that a successful outcome for the new care models programme will be forthcoming. While early indications show some encouraging signs of promise, the overall context in which the complex and ambitious changes are being implemented remains both fragile and fluid.
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spelling doaj-art-77b94a4ebe4f495d8d119fc3be2f8a452025-08-20T02:27:57ZengBMJ Publishing GroupBMJ Open2044-60552019-11-0191110.1136/bmjopen-2019-032107Lessons learnt from the implementation of new care models in the NHS: a qualitative study of the North East Vanguards programmeDavid J Hunter0Gregory Maniatopoulos1Jonathan Erskine2Bob Hudson311 Department of Rheumatology, Royal North Shore Hospital, St Leonards, New South Wales, Australia2 University of Leicester, Leicester, UK2 Durham University, Durham, UK3 Centre for Health Services Studies, University of Kent, Canterbury, UKObjective To examine lessons learnt from the implementation of five Vanguard initiatives in the North East of England.Design Data collection comprised semistructured interviews with key informants at each site.Setting The study took place across six local authority areas in the North East of England and within six clinical commissioning groups responsible for the delivery of each Vanguard’s aims and objectives.Participants Sixty-six interviewees with participants from five Vanguard initiatives in the North East of England, including senior clinicians, project leads and directors, commissioners, and healthcare managers.Results While the context for each Vanguard is separate and distinct, there also exists a set of common issues which have a regional dimension. Participants felt that the national programme helped to raise the profile of local change initiatives and also contributed to the wider understanding of regional service integration issues. At the same time our findings demonstrate that all five sites experienced, and were subject to, unrealistic pressure placed on them to deliver outcomes. Of particular concern among all sites was the sheer scale and pace of change occurring at the same time as the National Health Service was being tasked with making significant, if unrealistic, efficiency savings.Conclusions It is too early to conclude with any confidence that a successful outcome for the new care models programme will be forthcoming. While early indications show some encouraging signs of promise, the overall context in which the complex and ambitious changes are being implemented remains both fragile and fluid.https://bmjopen.bmj.com/content/9/11/e032107.full
spellingShingle David J Hunter
Gregory Maniatopoulos
Jonathan Erskine
Bob Hudson
Lessons learnt from the implementation of new care models in the NHS: a qualitative study of the North East Vanguards programme
BMJ Open
title Lessons learnt from the implementation of new care models in the NHS: a qualitative study of the North East Vanguards programme
title_full Lessons learnt from the implementation of new care models in the NHS: a qualitative study of the North East Vanguards programme
title_fullStr Lessons learnt from the implementation of new care models in the NHS: a qualitative study of the North East Vanguards programme
title_full_unstemmed Lessons learnt from the implementation of new care models in the NHS: a qualitative study of the North East Vanguards programme
title_short Lessons learnt from the implementation of new care models in the NHS: a qualitative study of the North East Vanguards programme
title_sort lessons learnt from the implementation of new care models in the nhs a qualitative study of the north east vanguards programme
url https://bmjopen.bmj.com/content/9/11/e032107.full
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