Research priority setting in care homes

The first study in the UK to establish research priorities for the long-term care of older people.

Background

This study is based on an idea originally conceived as a small pilot at the end of a previous care home study (PAAD Study), and was then developed into a larger UK-wide study.

It is widely recognised that the numbers of older people requiring long-term care are rising, with increasingly complex care needs. However there is little evidence base for much of the care provided in care homes, as less research takes place in this sector compared with hospitals and the community. Given the wide range of areas that require further investigation, and limited resources, one solution is to involve stakeholders in decisions about the priorities for future research.

Study design

This was the first study to establish the research priorities for older people requiring long-term care in the UK. Care home staff throughout the UK were invited to form an ‘expert panel’. They took part in a series of consensus building rounds using the Delphi technique to identify, and then rank, the topics they considered were most in need of further research. They were able to take part through a variety of methods: online survey, printed questionnaire, or by attending a local workshop event hosted by research networks.

Positive response and wide involvement

We found that a significantly larger group than anticipated responded to the last round as the link to the online survey was shared by interested individuals, groups and organisations. Care home staff who had not participated in previous rounds, and a number of health and social care professionals including doctors, social workers and care regulators, were keen to take part. The scores from these additional groups were not included in the main findings, but were analysed separately to assess the level of agreement with the findings from the main cohort.

Involving the public and the patients

This study was based on an idea originally conceived as a small pilot at the end of a previous care home study (PAAD Study), which was then developed into a larger UK wide study. The original study benefitted from the involvement of public and patient representatives throughout the design, development and conduct of both the main study and pilot, which in turn led to the development of this priority setting project.

Research impact

The early results show that the most highly rated themes were person-centred care, staffing levels and quality of staff in care homes, and end of life care. The next steps are further work to address the research questions identified as priorities during this study, and also to explore the evidence-practice gap for areas with existing evidence that are not currently implemented. Further work to explore the research priorities of residents, their families and friends would also be valuable.

Identifying priorities is increasingly being seen as an essential part of the research cycle, with a number of funders indicating that they wish to incorporate the findings of priority setting work into their commissioning processes. We hope that by engaging with clinicians, researchers and funding bodies, our findings will have a positive impact on the care of older people through ensuring that the future research agenda is focused on the areas of greatest need.