Local and national High Intensity Use services staff perspectives on implementation and organisational issues: potential implications for leaders and managers

Aims
High Intensity Use (HIU) services are aimed at reducing frequent use of Urgent and Emergency Care services in the NHS. This small-scale research investigates the staff perspectives of a local HIU service and a convenience sample of HIU staff across England on implementation and organisational issues.

Methods
The research uses a sequential mixed method approach of qualitative interviews with local staff of a single HIU service and a quantitative convenience sample survey of staff across England. The findings of the qualitative interviews formed the basis of the quantitative survey to analyse the validity and transferability of the qualitative findings.

Results
Findings reveal that despite overall ongoing resource constraints and structural changes, most respondents perceived their HIU service as achieving meaningful outcomes. Staff also consistently articulated a mixed model HIU structure to overcome negative aspects of the service and reinforce its overall positive effect. Significantly, there was a convergence of findings between the two sets of data.

Conclusions
This research makes relevant recommendations for HIU services in the future in terms of their management and leadership, service improvement, organisation and structure.

Implications for practice
The research’s combination of the local and the national perspective provides leaders and managers with triangulated and validated data on HIU services staff perspectives on their strengths, weaknesses, and the most appropriate HIU service structure for future development.