Abstract

We will use an in-depth longitudinal, case study approach. Our case study is a project designed to improve services through collaboration between general practitioners, community services, voluntary groups and acute specialists over an 18 month period in the Southall area of London. The project includes the development of a network of leaders across organisational and community boundaries to facilitate knowledge creation and exchange, and is directly linked with a programme of ‘whole system’ stakeholder conferences to create organisational learning and change, together with community development. Fieldwork will be undertaken in the three specific topic areas in which boundary spanning activities will be undertaken as part of the case study: (a) Dementia, (b) Child & Family Health, and (c) Depression & anxiety in people from black and ethnic minority backgrounds. In seeking to test our research hypothesis we will: provide a rich ethnographic account of the boundary spanning processes (horizontal and vertical) that occur within each of the three topic areas throughout the duration of the overall project (by means of non-participant observation, 360 degree interviews centred on individuals in the boundary spanning groups, participant (boundary spanning individual) diaries, and ongoing review of project documentation); monitor a range of routine datasets and quality indicators pertaining to the three topic areas across the whole PCT, making comparisons between the 26 general practices in Southall and practices from the remainder of the PCT; undertake a ‘before and after’ Knowledge, Attitudes and Practice questionnaire survey of a stratified, random sample of named staff in (a) each of the 26 general practices in Southall, (b) practices elsewhere in NHS Ealing, and (c) practices in neighbouring PCTs in West London; and conduct ‘before and after’ focus groups with patients & carers in each of the three topic areas as to their experiences of care and treatment .