Some of these findings are not unique to our study. Previous research highlights that tensions arise when other HCPs do not recognise that care home staff are familiar with their residents (Gage et al., 2012) and found disagreements regarding service responsibility (Jha, 2008). Limited professional development opportunities and low pay for formal carers in this sector are prevalent in countries other than the UK (Forbes & Neufeld, 2008). However, comparative work suggested that whilst health and social care services in the UK presented poor integration, care providers in the Netherlands functioned within collaborative networks (Kumpers, Mur, Hardy, van Raak, & Maarse, 2006). In addition, nursing homes in the UK have adopted a social care approach, whilst the Netherlands draws from a medical care model, thus enabling continuous access to doctors and other medical expert care for people with advanced dementia (Kumpers, Mur, Maarse, & van Raak, 2005) albeit at the cost of social needs.