Abstract
Introduction: Current United Kingdom legislation sets a precedence of person-centred HSC that meets the health and wellbeing needs of Service Users and their families through improved experiences. Despite this, current research in the field focuses on evaluation of services and models of integrated HSC, with fewer studies investigating person-centred experiences and needs of people who use HSC (1).
Aim and Methods: This qualitative multi-case study was designed with key stakeholders and aimed to explore the experiences and needs of people who use and deliver HSC at home, in a regional area of Scotland (UK). Eighteen participants were recruited (Service User [n=6]; Informal Carer [n=5]; HSC staff [n=7]) and. Service Users identified an Informal carer and HSC staff member (who helped them at home) to take part with them, creating a ‘case’ [n=7]. Qualitative data were collected via semi-structured interviews (December 2019 – March 2020). Principles of interpretive thematic analysis were employed to synthesise data and findings.
Key Findings: Supportive relationships and personal connections were instrumental in helping all participant groups to feel able to cope with their changing HSC needs and roles, promoting reassurance, information sharing, and reduced anxiety; when they were lacking, it negatively impacted upon Service Users' experiences of HSC. Service Users and Informal Carers wanted to connect with their local communities for support. These connections appeared more cohesive and collaborative than those with statutory services (NHS and Local Authority) because of personal connections with individual community members. Supportive relationships within a community were instrumental in meeting the HSC needs of their individual members. The support that statutory services provided did not always meet the needs of the people who were accessing or providing it, and they undervalued the support that communities provided.
Conclusions: Findings suggest a need to adopt Person-centred, Relationship based HSC to encourage meaningful connections and improve experiences of accessing and providing it. This study offers insight into indicators for improved HSC and offers HSC organisations the opportunity to explore service redesign using co-designed research evidence. Findings suggest that co-produced, community driven, HSC services that meet the needs of the people who use them, as defined by those people themselves, should be encouraged.
Implications for Transferability and Limitations: Although findings are transferrable to other locations, the regional context of data collected could be observed as a limitation. To facilitate the transferability of this study, clarity and transparency of methods and analysis was promoted through thick description and reflexive journaling. Furthermore, although the target number of total participants were recruited, one of the seven cases had only staff member data, and a second had Service User and staff member data only. Successful recruitment of all three participant groups to each case may have further enriched the data.
References
1.Henderson L, Bain H, Allan E, Kennedy C. Integrated health and social care in the community: A critical integrative review of the experiences and well-being needs of service users and their families. Health & Social Care in the Community. 2021;29(4):1145-68.