An evidence synthesis of the international knowledge base for new care models to inform and mobilise knowledge for multispecialty community providers (MCPs)

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Abstract

Background

NHS England’s Five Year Forward View (NHS England, Five Year Forward View, 2014) formally introduced a strategy for new models of care driven by simultaneous pressures to contain costs, improve care and deliver services closer to home through integrated models. This synthesis focuses on a multispecialty community provider (MCP) model. This new model of care seeks to overcome the limitations in current models of care, often based around single condition-focused pathways, in contrast to patient-focused delivery (Royal College of General Practitioners, The 2022 GP: compendium of evidence, 2012) which offers greater continuity of care in recognition of complex needs and multimorbidity.

Methods

The synthesis, an innovative combination of best fit framework synthesis and realist synthesis, will develop a “blueprint” which articulates how and why MCP models work, to inform design of future iterations of the MCP model. A systematic search will be conducted to identify research and practice-derived evidence to achieve a balance that captures the historical legacy of MCP models but focuses on contemporary evidence. Sources will include bibliographic databases including MEDLINE, PreMEDLINE, CINAHL, Embase, HMIC and Cochrane Library; and grey literature sources. The Best Fit synthesis methodology will be combined with a synthesis following realist principles which are particularly suited to exploring what works, when, for whom and in what circumstances.

Discussion

The aim of this synthesis is to provide decision makers in health and social care with a practical evidence base relating to the multispecialty community provider (MCP) model of care.

Systematic review registration

PROSPERO CRD42016039552.

Electronic supplementary material

The online version of this article (doi:10.1186/s13643-016-0346-x) contains supplementary material, which is available to authorized users.

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Most cited references 31

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A hierarchy of evidence for assessing qualitative health research.

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The objective of this study is to outline explicit criteria for assessing the contribution of qualitative empirical studies in health and medicine, leading to a hierarchy of evidence specific to qualitative methods. This paper arose from a series of critical appraisal exercises based on recent qualitative research studies in the health literature. We focused on the central methodological procedures of qualitative method (defining a research framework, sampling and data collection, data analysis, and drawing research conclusions) to devise a hierarchy of qualitative research designs, reflecting the reliability of study conclusions for decisions made in health practice and policy. We describe four levels of a qualitative hierarchy of evidence-for-practice. The least likely studies to produce good evidence-for-practice are single case studies, followed by descriptive studies that may provide helpful lists of quotations but do not offer detailed analysis. More weight is given to conceptual studies that analyze all data according to conceptual themes but may be limited by a lack of diversity in the sample. Generalizable studies using conceptual frameworks to derive an appropriately diversified sample with analysis accounting for all data are considered to provide the best evidence-for-practice. Explicit criteria and illustrative examples are described for each level. A hierarchy of evidence-for-practice specific to qualitative methods provides a useful guide for the critical appraisal of papers using these methods and for defining the strength of evidence as a basis for decision making and policy generation.

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Literature for a systematic review on the student experience of e-learning is located across a range of subject areas including health, education, social science, library and information science. To assess the merits and shortcomings of using different search techniques in retrieval of evidence in the social science literature. A conventional subject search was undertaken as the principal method of identifying the literature for the review. Four supplementary search methods were used including citation searching, reference list checking, contact with experts and pearl growing. The conventional subject search identified 30 of 41 included references; retrieved from 10 different databases. References were missed by this method and a further 11 references were identified via citation searching, reference list checking and contact with experts. Pearl growing was suspended as the nominated pearls were dispersed across numerous databases, with no single database indexing more than four pearls. Searching within the social sciences literature requires careful consideration. Conventional subject searching identified the majority of references, but additional search techniques were essential and located further high quality references.

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Validity in qualitative research.

Herbert S Chase, C L Mandle, Scott R Whittemore (2001)

Much contemporary dialogue has centered on the difficulty of establishing validity criteria in qualitative research. Developing validity standards in qualitative research is challenging because of the necessity to incorporate rigor and subjectivity as well as creativity into the scientific process. This article explores the extant issues related to the science and art of qualitative research and proposes a synthesis of contemporary viewpoints. A distinction between primary and secondary validity criteria in qualitative research is made with credibility, authenticity, criticality, and integrity identified as primary validity criteria and explicitness, vividness, creativity, thoroughness, congruence, and sensitivity identified as secondary validity criteria.

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Author and article information

Contributors

Alison Turner:

ORCID: http://orcid.org/0000-0003-3075-0868

alison.turner14@nhs.net

Abeda Mulla: abeda.mulla@nhs.net

Andrew Booth: a.booth@sheffield.ac.uk

Shiona Aldridge: shiona.aldridge@nhs.net

Sharon Stevens: sharon.stevens7@nhs.net

Fraser Battye: fraser.battye@nhs.net

Peter Spilsbury: peter.spilsbury1@nhs.net

Journal

Journal ID (nlm-ta): Syst Rev

Journal ID (iso-abbrev): Syst Rev

Title: Systematic Reviews

Publisher: BioMed Central (London )

ISSN (Electronic): 2046-4053

Publication date (Electronic): 1 October 2016

Publication date PMC-release: 1 October 2016

Publication date Collection: 2016

Volume: 5

Electronic Location Identifier: 167

Affiliations

[1 ]Strategy Unit, Midlands and Lancashire Commissioning Support Unit, West Bromwich, UK

[2 ]School of Health and Related Research, University of Sheffield, Sheffield, UK

Author information

Alison Turner http://orcid.org/0000-0003-3075-0868

Article

Publisher ID: 346

DOI: 10.1186/s13643-016-0346-x

PMC ID: 5045634

PubMed ID: 27716415

SO-VID: 46776d63-485e-47bb-8d6d-93779c34a958

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 30 June 2016

Date accepted : 20 September 2016

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100002001, Health Services and Delivery Research Programme;

Award ID: 15/77/15

Award Recipient : Alison Turner

Custom metadata

ScienceOpen disciplines: Public health

Keywords: primary health care,innovation, organizational,community health services,integrated health care

Data availability:

ScienceOpen disciplines: Public health

Keywords: primary health care, innovation, organizational, community health services, integrated health care

An evidence synthesis of the international knowledge base for new care models to inform and mobilise knowledge for multispecialty community providers (MCPs)

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Abstract

Background

Methods

Discussion

Systematic review registration

Electronic supplementary material

Related collections

Chinese Journal of School Health

Most cited references 31

A hierarchy of evidence for assessing qualitative health research.

Literature searching for social science systematic reviews: consideration of a range of search techniques.

Validity in qualitative research.

Author and article information

Contributors

Journal

Affiliations

Author information

Article

History

Funding

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