Why is the research needed?
It is important to make sure that older people who go into hospital return home as quickly as possible and then stay at home. This is because often older people make a quicker recovery at home, while freeing up space in hospital for other people to be treated. However, older people often find themselves ‘stuck’ in hospital for longer than they need to be, because services to support them after they leave hospital might not be available. To solve this, local authorities social care services are starting to offer older people widely available digital ‘smart’ technologies such as smart speakers to help them move back home. These services are often new, differ significantly between regions, and are rapidly changing. As such, we do not yet fully understand what these services look like, how services are using these new technologies, or whether they help older people to return and remain at home.
What are we doing?
We will identify what helps or hinders implementation of digital technologies deployed within post hospital discharge and reablement services (PPHDRS) in social care for older people (aged 65+) with assisted living needs. We will evaluate the development, implementation, adoption, and scalability of digital PHDRSs to support older people. We will also identify outcomes of these services, explore feasibility of integrating routine service and technology data, and identify key factors influencing PHDRS adoption and abandonment. The study will develop a Participatory Theory of Change (ToC), informed by empirical data and co-produced with stakeholders, to support the scaling and sustainability of PHDRSs across social care.
A mixed-methods design will be used, structured through six interconnected work packages. The NASSS (Non-adoption, Abandonment, Scale-up, Spread, Sustainability) framework and its associated complexity assessment tool (NASSS-CAT) guide the process evaluation. The study will be conducted in three sites (Middlesbrough, Oxfordshire, and Bristol and its surrounding region) reflecting diverse service models, technological configurations, and population needs. There are a number of complementary and overlapping work packages (WPs):
- WP1 - A scoping review will identify existing evidence
- WP2 - Mapping and feasibility analysis of routine sensor and outcomes collected data from PHDRS.
- WP3 - An ethnographic process evaluation, including ethnographic observation of routine PHDRS service delivery over a 24-month period and qualitative interviews with service providers, clients, and informal carers.
- WP4 – A synthesis of findings to co-develop a Participatory Theory of Change with stakeholders across LAs, clients, carers and partners.
- WP5 embeds co-production with older social care users and carers throughout the research process.
- WP6 focuses on knowledge mobilisation and impact, co designed with study partners to benefit them and the wider social care ecosystem.
How are we working with communities, services and organisations?
We have three partner study sites:
- Innovate Oxfordshire (Oxfordshire County Council)
- Bristol, North Somerset and South Gloucestershire Integrated Care Board
- Middlesborough Council
We will work with local social care teams delivering PHDRS in each of these partner study sites to follow delivery of services over a two year period. This work will involve interviews with service users, clients and informal carers, as well as ethnographic observations of service delivery activities. A member of each service is included as a co-investigator in the project team, and will coordinate research activities across the three study sites.
The co-production work will be supported by Age UK Bristol, Rekindle and Shaping our Lives.
Each partner will support a series of co production workshops in each fieldwork area. Workshops will involve older adults with experience of using social care services, and will be used to contribute to collection and analysis of project research data, development of the theory of change, and development of resources and tools to support future delivery of PHDRS’s in social care.
What will the impact and benefits of this research be?
This project will deliver new knowledge and critical insights on how digital PHDRSs function in social care, types of data collected, technology/service configurations and implementation factors facilitating or constraining PHDRS delivery locally and at scale. The Participatory Theory of Change will offer a scalable framework applicable across varied social care settings. Data visualisations will use routine service data to monitor and improve outcomes. Impacts include greater PHDRS deployment and integration across Local Authorities, more rapid hospital discharges, delayed re-entry to hospital or into care, and improved client and carer outcomes.
What do we have planned for knowledge mobilisation and implementation?
Knowledge mobilisation activities will include:
- Project website (www.dialogue-project.org) hosting project updates and outputs e.g., blogs, videos, podcasts
- Outputs via academic and professional journals and conferences to extend the social care evidence base
- Briefing papers, press releases and knowledge exchange events for policy and practice audiences
- Data visualisation tools and a prototype data dashboard will support analysis of routine service data in LAs
- Resource toolkits will support local implementation of new technologies in PHDRSs
- Public facing easy to read summaries and resources to support access to services will be developed with co production groups.
- Local demonstrator/lending libraries of available technologies in each LA, guides for practitioners, clients and carers will support wider promotion of available technologies in PHDRS
Related papers, outputs and resources
Will be added when available.
Project SoDA09
Project SALLT08
Project MH57
Project PEDHSC47
Project SALLT07
Project SALLT02