I am surprised that anyone should be surprised at the findings on GPs' lack of engagement. In my long experience of the NHS GPs have always seen themselves as 'above' the interdisciplinary working demanded of this area of care. The only remedy is a root and branch change to GP education.
I find the above summary unhelpful as a policy maker - all the literature suggests that despite investment these integrated care/care coordination projects do not improve patient and carer staisfaction or reduce emergency admissions. Are they worth the investment? So far the literature says no. SO when you say these are the key design features of "successful" care coordination you need to say what you are using as a measure of "success"? Did you see increased patient and carer satisfaction and or improved health outcomes and or reduced emergency admissions?
In response to Margaret, the case sites chosen for study were selected because they were able to demonstrate that care experiences to the user (patient or carer) had reportedly improved as had care outcomes, and that this had been achieved at the same or lower costs. The literature on care co-ordination is overwhelmingly positive when it comes to improving care experiences
My clients are main carers of such patients. Over the last two years, these clients report significant improvements in care and treatment plans due to the involvement of our skilled family representative services. A family representative is effective as a care coordinator because they help the family secure improvements in quality via the numerous appeals and complaints processes. This also leads in the longer term to improvements in quality, staff training, integration and shifts in adverse cultural attitudes of NHS and Social Services personnel towards patients.