Published on 16 January 2018 doi: 10.3310/signal-000528

Long-term relationships and joint working between community health practitioners and care homes are the keys to improving appropriate hospital admissions and access to medications. Additional payments for GPs, jointly agreed protocols, clear role specifications and structured systems have impact only if they trigger and sustain collaborative working.

This realist evaluation in 12 English care homes for older people explored contexts for ‘relational working’ in three service delivery models alongside the theoretical mechanisms by which this type of working achieves better outcomes for residents.

The researchers report that care home residents use a wide range of external NHS services including GPs. They point out that before their research primary care provision in care homes was thought to be inadequate compared with that received by older people in the community. This could potentially worsen the impacts of multiple health conditions on residents’ quality of life.

The findings support efforts at integration set out in the NHS Framework for enhanced health in care homes in England. Training is needed for care home staff and NHS practitioners in the areas of dementia and medicines management, and can be applied to the design of services elsewhere.

Read the full article to uncover the answers to the questions following….

Why was this study needed? What did this study do? What did it find? What does current guidance say on this issue? What are the implications?

NIHR Evidence source: NIHR Evidence – What works to support residents’ health in care homes and why – Informative and accessible health and care research