Table 5.

Model components not consistently delivered as intended

Delivered as intended	Not delivered as intended
1. An underpinning conceptual model of collaboration
The PARTNERS model included manualised and planned care, a case-manager, support for self-management through coaching, making specialist mental health workers readily available to primary care workers and recording in shared records. The CHIME framework was included as a specific focus of the intervention.
2. Identification of patients: method
Service users were identified from records and discussion with secondary care staff
3. Identification of patients: setting
Service users were identified in both primary and secondary care settings.
4. Provider integration
In two sites:	In one site:
• Care partners maintained allocated time to carry out PARTNERS role  • Primary care services accommodated the care partner’s needs	• care partner required to return to secondary care role • primary care services did not give care partners access to necessary resources (e.g.: rooms, access to IT)
5.Multi-disciplinary working
In one site:	In all sites:
• supervision took place routinely	• limited evidence of integration into primary care teams
In all sites:  • access to psychiatric consultation was available	In two sites:  • supervision was not delivered consistently
6. Systematic communication between providers
In all sites:	In all sites
• a few examples of care partners making helpful entries in records, making appropriate requests to GPs and attending practice meetings	• very limited evidence of recording in shared records • very limited evidence of interaction between care partners and primary care teams
7. Case management
In all sites:
• evidence of care partners liaising with other providers in response to goals identified by service users or change in mental health
8. Study protocols / treatment algorithms
In all sites
• care partners and supervisors were aware that the manual should guide care and evidence that they accessed the manual
9. Systematic monitoring / follow up
In one site:	In one site:
• repeated measures used consistently	• no evidence that repeated measures used • lack of regular follow up by care partner
In two sites:  • regular follow up provided	In one site:  • repeated measures used but not in a way that was consistent with the ethos of the model
	In one site:  • uncertainty about whether variation in intensity could include duration as well as frequency of contact
10. Pharmacological intervention
In all sites
• evidence that this had been discussed as a possible personal goal and psychiatric consultation sought where relevant
11. Psychological intervention
In one site:	In all sites:
• coaching approach used to a large extent	• resources provided in the intervention manual to support coaching processes were rarely used
	In two sites:  • very limited evidence of coaching approach being used
12. Education for mental health / primary care providers
In all sites:
• training provided
13. Patient education / promoting self-management
In one site:	In two sites:
• motivational approach used to a large extent	• very limited evidence of motivational approach being used
14. Shared decision making with patients
In one site	In all sites:
• collaborative style of interaction largely present between care partner and service user	• service user guide intended to support service user participation not widely used
	In two sites:  • very limited evidence of a collaborative style of interaction between care partners and service users