Table 4 Description of implementation context in the four case study localities
GM Localities | Start date and number of care homes using tracker (at time of interviews) | Existing infrastructure, work processes and stakeholders involved | Training received by care home interview participants |
|---|---|---|---|
Locality 1 | Apr 2020 Majority of 54 homes across locality; roll-out mandatory. | Clinicians: Prior to roll-out all care homes already remotely supported by a digital hub of clinical staff. Hub backed by mature digital reporting systems, and lead clinicians closely involved in developing/piloting both the falls app and the COVID-19 symptom tracker in a small number of locality homes, and linking with a team of community pharmacists. LA: Involved in brokering of relationships with care homes and promotion of tool | Mixture of ‘light touch initial’ and'in-depth’ one-to-one model |
Locality 2 | Aug 2020 Majority of 43 homes across locality; roll-out advisory. | Clinicians: One GP practice covering residents in most homes co-located with palliative care/dementia nursing staff and pharmacist. Lead GP supportive in principle of tracker implementation. Digital infrastructure challenged. LCO: Existing remit for care home quality and brokered relationships with homes. Health improvement organisation: Project management of tracker roll-out; follow-up of homes post on-boarding and tracking data input. | ‘In-depth’ group webinar model |
Locality 3 | Oct 2020 9 of 65 homes across locality; roll-out voluntary. | Clinicians: No single GP practice covering care homes; some practices aligned with particular homes but generally different GP practices covered different residents. Low interest in tracker among GPs. CCG: Involved in some brokering of relationships with care homes and informal follow-up. LA: Mainly assisted in helping to provide digital kit to homes. | ‘Light-touch subsequent’ model |
Locality 4 | Nov 2020 7 of 44 homes across locality; roll-out voluntary. | Clinicians: No single clinical team linking with homes but multiple GP practices covering different residents. Low level of engagement among GPs; digital infrastructure challenged. Team of community nurses/AHPs providing support to homes for COVID response but low engagement with tracker. LA: Involved in brokering relationships with homes and assisting with project set-up; providing support to homes; linking with CCG. CCG: Engaging PCNs to promote tracker; linking with LA. | ‘Light-touch subsequent’ model |