Give nurses a greater voice in implementing care in the community, say researchers 

Newly-published research led by Gemma Prebble, Nurse Lecturer, Bangor University, explored the role of nursing in using collaborative integrated models of care in this important area.  

These are approaches to delivering health care that involve working in a team or alongside other providers with a high degree of collaboration and communication between them. This can include working with service users, professionals and organisations outside the health care sector, such as housing providers and employers. 

This has led to a growth of interest in developing integrated models of care supports innovative working across conventional boundaries.  

The research outlines the challenges experienced by health and care service providers in meeting the needs of communities.  

The former Occupational Therapy assistant who went on to become a Community Staff Nurse following graduation co-authored the scoping review with her Doctoral Supervisor, Dr David Evans.  

Although they highlighted the importance of new collaborative approaches promoting holistic service delivery which provides support that looks at the whole person not just their health needs, the researchers demonstrated a “paucity of evidence” giving voice to the experience of nurses and nurse leadership in implementing innovative nurse-led models.  

They adopted a systems approach to explore the complex dynamics of integrated care, with innovative application of existing conceptual models guiding examination of the relationship between core components. In the research, they used thematic analysis to identify and present recurring patterns or themes in the data. 

This highlighted the complexity of the nursing role within the context of implementing  integrated working and identified both challenges and opportunities for nurses implementing new ways of working.  

Gemma Prebble, undertaking a Professional Doctorate in Implementation Science at the School of Health Sciences, said, “Nurses are underrepresented in this area of research. This is a concern because they are the ones who are on the frontline delivering care in the community and this means that the communities they’re serving aren’t being heard either.  

“It’s clear that nurses and nurse leadership should be given a much greater voice when it comes to examining and developing the models used when implementing care in the community. For care in the community to be implemented effectively you need a whole host of people and organisations in very complex systems to work collaboratively.  

“Unfortunately, all too often you have situations where essentially the left hand doesn’t know what the right hand is doing because the people and the organisations involved in care aren’t communicating with each other as well as they could be. Nurses play a key role when delivering care in practice and its only right that they should also play a key role when developing the models that underpin it.”   

She added, “I found a love for research and a passion for District Nursing studying for an undergraduate degree in Nursing at Bangor University. 

“My foundation as a community staff nurse in a rural community has shaped my career in health care and combined with an interest in service development and innovation, has provided direction for my academic career.  

“Returning to academia Bangor University has supported me to explore this passion further, encouraging me to commence studying for a Professional Doctorate in Implementation Sciences alongside my role as a nurse lecturer.  

“The network of colleagues I have found within the School of Health Sciences have given invaluable guidance to me as an early career academic, helping me to achieve an aspiration, my first research publication, a scoping review exploring innovative models of working in district and community nursing.  

“The complex challenges of delivering effective health and care services have led to increased interest in understanding the development and implementation of integrated care services. Integration of primary and community services, and health and social care, appears of particular importance in addressing health needs within communities.”   

The paper Exploring the role of nursing in implementation of collaborative integrated models of care in the community: a scoping review, which has been published by the Journal of Integrated Care, can be read here: https://doi.org/10.1108/JICA-07-2024-0035