Aim: To explore the process employed in the development of a population health framework and documentation for managing community nursing caseloads. Background: No formal structure exists to validate and link local health information collected by Irish public health nurses to a wider epidemiological framework. Neglect of this bottom up information forfeits opportunities to resource and manage public health nursing services. Design: Action research methods guided the development of the framework in one geographic area in Dublin and 34 participants engaged in Stringer's (1996) Look, Think and Act cycle. Results: The framework identified four patient registers: family health, chronic sick/disability, older adults and acute care, which identify public health outcomes for discussion within the caseload analysis process and can predict risk factors in local populations. Conclusions: The use of the developed documentation identified a framework that describes caseloads in primary care and provides nurse managers with an evidence base to allocate resources, match skill mix to need, and estimate future workforce requirements.

This article explores perceptions of time reported by service users, family carers, care workers, nurses, social workers and agency managers across home support services for older adults in Ireland. The findings are organised around: time spent waiting for care; time spent ‘processing’ care across primary and secondary care boundaries; time and person-centred care; and time, technology and communication. Time emerges as a problematic aspect of all processes and structures around formal home care, suggesting that addressing issues around time is central to resolving systemic challenges. Greater flexibility in time allocation and effective communication among stakeholders could improve experiences of care.