Challenges of implementing quality of care into practice among care providers for people with complex needs

  • Olanrewaju Abayomi Ajayi

Student thesis: Doctoral Thesis


Background: The demand for, as well as the provision of quality in care provision, and the ability to satisfy such demand, has been one of the key topics among both scholars and healthcare professionals in recent decades. According to Cornwell (2012), Rosengard et al. (2007), Goodwin et al. (2014) and the Kings Fund (2016), the number of people with complex needs is expected to increase rapidly in the next decade, both in the UK and worldwide. This is likely to create increasing pressures on the system of care provision and the case management of people with complex needs, as there is insufficient funding available in this industry in the UK, due to budgetary restrictions.

Aims: The study aims to identify the challenges experienced by care providers in
implementing quality of care in practice in the case of persons with complex needs. This aim is achieved by considering the perspectives of different stakeholders in the process: care providers, health professionals, professional carers’, and people with complex needs. This exploration of different perspectives provides new insights into overcoming such challenges and contributes to the potential for improvement of care services for people with complex needs.

Methods: The methodological part of the current study was based on semi-structured interviews, which were conducted with a cross-section of participants selected from 10 care centres. Six participants were recruited from each of the four stakeholder categories, namely senior managers, health professionals, professional carers’, and people with complex needs (service users) (24 participants in total). The interview time, date, and choice of venue were arranged according to the participants’ convenience. This promoted a more relaxed interview environment for the recruited participants. Thematic analysis was performed on the responses received from the participants, in order to derive meaningful information from the data collected. This type of data collection approach was later supplemented by qualitative content analysis of the interviews.

Findings: The research revealed a set of key negative experiences that are seen as obstacles to quality care by different stakeholders in the provision process. The main challenges were divided in to five themes: funding, staffing, compliance, quality of life for people with complex needs, and communication.

Having explored a qualitative dataset originating from 24 interviews, with the key stakeholders engaged in the provision of care services for people with complex needs, it was possible to formulate a number of themes that are of major concern, especially to the care providers, along with other stakeholders in the modern field of healthcare services.
Date of AwardFeb 2020
Original languageEnglish
Awarding Institution
  • University of Portsmouth
SupervisorIsobel Helen Ryder (Supervisor) & Annabel Tremlett (Supervisor)

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