2014 Conference Presentation
Dementia is recognised nationally in the UK, and internationally, as a priority issue. In addition to seeking better prevention strategies and treatments, there is a need for more innovations in service models for better health and social care systems to be able deliver effective, quality support to those needing it. In previous work we have described an innovative model of integrated dementia care located in a primary care clinic in Gnosall, Staffordshire, England. The model has 88 been demonstrated to be promising in a number of respects, including providing speedy assessment and diagnosis, delivering high quality, personalised care in people’s communities, and doing so in an economical manner.
The model is now being rolled out across a larger geographical area and many more practices. Once, however, promising innovations are established as worthy of larger-scale implementation, new challenges present themselves. This is often when innovations become diluted and are seen to fail. In this paper we will draw on the relevant literature and lessons thus far from the rollout of the Gnosall model to develop a better assessment of challenges in scaling up innovations in care and means of tackling them.
The levels of challenges include those over which innovators have a high degree of control (such as ensuring a robust governance framework around the roll-out, and clearly articulating the model and its core principles), those over which they only have varying amounts of influence (including managing new partnerships and seeking to ensure their understanding and buy-in), and those issues imposed externally and which have to be managed (for example, nationally imposed dementia diagnosis targets). This paper reflects on the challenges of scaling up innovative models of care in general and dementia care in particular.