Evaluating the nursing midwifery and health visiting contribution

Nursing, midwifery and health visiting contribution to models of chronic disease management

Government policy has suggested that nurses play a greater role than before in the health service response to people with long-term conditions and in particular in assuming the case management role.

This is attributable to increasing numbers of people requiring sustained and coordinated care, an environment of changing health and social care labour markets, an increasing diversity of health and social care provision and greater patient/user choice. 

This study, led by Prof Claire Goodman, Prof Vari Drennan and CRiPACC staff Helen Masey, is designed to inform those engaged in decision making for service organisation and delivery.

It will enable them to determine the extent and impact of nurses working as case managers within different models of care delivery on patients and service utilisation and its place within complex health and social care networks.

Aims

• To demonstrate the range, types and impact of the contribution of nursing, to different models of chronic disease management
• To make recommendations about how these contributions can be maximised and sustained
• To help disseminate findings as widely as possible to service users, service-planners, commissioners and providers of services for people with long-term conditions as well as to those responsible for the recruitment, education and development of the nursing workforce

Objectives

• Identify the drivers that have stimulated the development of models of chronic disease management that involve NMHV and map their development over time
• Describe the range and type of chronic disease models and the ways that they involve service users and carers
• Describe and classify the roles and responsibilities of NMHVs in current models of chronic disease management
• Evaluate the impact of NMHVs' contribution to the experiences of patients, service users, professionals and carers
• Identify the factors that enable NMHVs to contribute most effectively to successful outcomes of care
• Identify the factors that sustain the models of care over time
• Describe the mechanisms that are used for knowledge transfer and enhance learning between all members of the care team and the wider organisation
• Evaluate the impact of the NMHV contribution upon the cost, quality, effectiveness and organisation of the care provided

Study Phases

Phase 1

National overview (macro level analysis): Review of policy and research on the nursing contribution to chronic disease management

Service Organisation and implementation (meso level analysis) A scoping exercise of key informants from up to 100 NHS trusts  and Local Health Boards across England and Wales to survey and establish how the nursing contribution to long term care has been interpreted and implemented

Phase 2

User experience and outcomes (micro level analysis): Drawing on the principles of realist evaluation and using an in depth comparative case study design we are studying prospectively over 9 months the patient experience (n=60) and nursing contribution (n=12) within four different models of care delivery for long term conditions that are provided in three Primary Care Trusts.

Project information

ENCaM Evaluating the Nursing Contribution to case Management of people with long term condition.

Project funder: National Institute for Health Research Service Delivery Organisation (SDO).

Collaborating Investigators and Centres: St Georges and Kingston University, University of Surrey, Kings College London and University College London.

Project Duration: Three years. Completed 2010.

For further information, please contact: Prof Claire Goodman