Scale and spread of innovation in health and social care: Insights from the evaluation of the New Care Model/Vanguard programme in England.

IF 1.9 4区 医学 Q3 HEALTH POLICY & SERVICES Journal of Health Services Research & Policy Pub Date : 2023-04-01 DOI:10.1177/13558196221139548
Julie MacInnes, Jenny Billings, Anna Coleman, Rasa Mikelyte, Sarah Croke, Pauline Allen, Kath Checkland
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Abstract

Objective: Little is known about how to achieve scale and spread beyond the early local adoption of an innovative health care programme. We use the New Care Model - or 'Vanguard' - programme in the English National Health Service to illuminate the process, assessing why only one of five Vanguard programmes was successfully scaled up.

Methods: We interviewed a wide range of stakeholders involved in the Vanguard programme, including programme leads, provider organisations, and policymakers. We also consulted relevant documentation.

Results: A lack of direction near the end of the Vanguard programme, a lack of ongoing resources, and limited success in providing real-time monitoring and evaluation may all have contributed to the failure to scale and spread most of the Vanguard models.

Conclusions: This programme is an example of the 'scale and spread paradox', in which localism was a key factor influencing the successful implementation of the Vanguards but ultimately limited their scale and spread.

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健康和社会护理创新的规模和传播:来自英格兰新护理模式/先锋项目评估的见解。
目的:对于如何在早期的地方采用创新的卫生保健方案之外实现规模和传播知之甚少。我们使用英国国家卫生服务体系的新护理模式(或“先锋”)项目来阐明这一过程,评估为什么五个先锋项目中只有一个成功地扩大了规模。方法:我们采访了广泛参与先锋项目的利益相关者,包括项目负责人、供应商组织和政策制定者。我们还查阅了相关文件。结果:Vanguard项目在接近尾声时缺乏方向,缺乏持续的资源,以及在提供实时监测和评估方面有限的成功,这些都可能导致大多数Vanguard模式无法扩展和推广。结论:该方案是“规模和传播悖论”的一个例子,其中地方主义是影响先锋队成功实施的关键因素,但最终限制了其规模和传播。
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来源期刊
CiteScore
4.40
自引率
4.20%
发文量
39
期刊介绍: Journal of Health Services Research & Policy provides a unique opportunity to explore the ideas, policies and decisions shaping health services throughout the world. Edited and peer-reviewed by experts in the field and with a high academic standard and multidisciplinary approach, readers will gain a greater understanding of the current issues in healthcare policy and research. The journal"s strong international editorial advisory board also ensures that readers obtain a truly global and insightful perspective.
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