To develop a vision for primary care which enables consistent access to healthcare that reflects care home residents’ needs and priorities and how that can be achieved within current structures and resources.


The COVID-19 crisis highlighted the complex relationship between care homes and primary care and inequalities in service access and quality of care. Studies and national guidance have identified new ways of working to enable GPs and others to work well with care homes. Care home staff and residents’ priorities, however, are not the basis for these recommendations. COVID-19 demonstrated the essential work of care homes but the minimal opportunities to influence and access support. There is a need to co-create ways of working with GP-led services that ensure people working and living in care homes are equal and valued partners.


This fellowship will use a co-design approach (Appreciative Inquiry) working with care home staff, residents and their families, GPs, and community specialists to develop and improve services provided to care homes. Drawing on recent experiences from the pandemic it will involve group discussions and interviews to take learning from what works well to identify key principles of working together and what needs to be in place to achieve and sustain change to improve care home residents and staff access to healthcare.

Dissemination .

The findings will be shared widely to reach different audiences and raise awareness about what needs to be in place to improve care. Plain language summaries will be created with the help of care home residents and staff. Findings will also be published in academic journals and presented at scientific conferences.

Theoretical framework.

This project will adopt a co-production approach called, Appreciative Inquiry (AI). AI is a methodology that focuses on the positive – on what went right, on what was done well – and builds on these good news stories. AI theorizes change is achieved by heeding what participants want more of. It acknowledges failures and challenges but focuses on narratives and evidence of best practice to apply this learning where change is needed. It is an iterative process that maps existing approaches, identifies participants’ priorities and ideas, and uses learning gained from experience to design and implement improvement.

AI’s 4D cycle of Discovery, Dream, Design and Destiny will be employed to enable participants to share and jointly learn from stories and existing evidence of best practices to co-produce a vision and activities that support and sustain primary care-care home working.

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Research Partners.