Dementia care coordinator service in Kent and Medway: a realist evaluation protocol

Abstract

Background: Dementia care is a key priority for both NHS England and the UK government. National guidelines highlight the importance of care coordination to address the challenges people living with dementia and their carers can encounter when trying to access the health and care system. To counter these challenges, Kent and Medway Integrated Care Board (ICB) have recently implemented a proactive dementia care coordinator (DCC) service to support people with dementia and their carers from pre-diagnosis to end-of-life care. Aim: To understand how the DCC service works (or does not work), for whom, and in what circumstances. The findings will inform service development and future investment decisions. Design & setting: This study will use a realist approach to evaluate the DCC service in Kent and Medway ICB, south-east England, which has a population of 1.9 million, comprising 42 primary care networks (PCNs; groups of general practices) each having a DCC. Method: An initial programme theory will be developed from existing literature, and in collaboration with stakeholders. Mixed methods, including questionnaires to DCCs, service provider metrics, and qualitative interviews, will be used to collect data on service provider and service user experiences. Interpretive comparative analysis and narrative synthesis, including evaluation of service costs against outcomes, will produce a refined final programme theory. Results: The results from this project will produce evidence-based recommendations to help improve service delivery and possible service expansion. Conclusion: This protocol describes a realist evaluation designed to investigate the recently implemented DCC service in Kent and Medway ICB.