In Italics = Data Source

Additional file 1: Table S4: Showing examples from each of the identified domains and stakeholder

groups which illustrate transitions from red to green (August 2013-August 2014)

Stake- RED – problems identified AMBER – actions and review GREEN - outcome holder S AIW Nov-13: AIW case workers still Dec-13: AIW staff are actively May-14: marketing materials E report being focussed on involved in preparing done, website finalised. New N practical case work – seeing ‘marketing’ materials – writing case worker in post. Team have S their roles as service delivery the text for study leaflet, a clearer sense of what the E rather than leading a change in podcast, press release. Text project aims to do, and what M approach/service (LC that succinctly describes what their role is within it. (project A observation of case workers in BB Is and why it is distinct. team meetings) K practice) (project team meetings) I Practice Nov-13: Very limited patient Jan-14: still very limited Aug-14: project now functioning N Team referral – staff report (to LC and referrals (Project data base, in 5 practices (project data G case workers) that they don’t team meeting reviews) base, team meetings, understand how BB is distinct May-14: referral process in observation LC) from usual mental health care, place, but practice staff still don’t want to disrupt continuity confused how BB differs from for patients. Observation of BB another 3rd sector service in practice, feedback at project introduced during the project meetings time period (PCAL). Patients Nov-13: patients arriving at Jan-14: working with [a local Aug-14: reported findings from appointments not knowing why social enterprise marketing case workers that patients they are there (case worker company] to produce a range of arriving with clearer sense of report, LC observation) ‘marketing materials’ to explain the service. Patients reported to potential and current service that the leaflets (especially the users what the service is doing. ‘how BB helped me’ leaflet – Working with User group at available from the authors - AIW to suggest changes were helpful) Policy Nov-13: meeting with CCG May-14: meetings with CCG Sept-14: CCG report interest in postponed (again) ongoing. Recognition of shared hearing about our work, notably areas of interest, no firm plan when have output data for integration as yet E AIW Nov-13: case workers leading Sept-14: wider AIW team have Sept-14: AIW case workers N the project, driving forward. But better understanding of the BB leading the service delivery and G resistance from wider AIW team project, although resistance the evaluation side (blurring of A (don’t understand how BB fits appears transiently (linked roles) G within broader portfolio of work especially to funding changes E at the charity (including PCAL and insecurity about other M project). BB seen as a threat) projects) E Practice Nov-13: lead GP engaged, other Jan-14: identified a local Sept-14: In 6 practices (though N Team GPs enthusiastic in meetings champion (receptionist) within little engagement from one. But T but not referring patients. Like the practice team to drive given the evaluative nature of the idea but not the practice? forward the service the project, decided to keep in Aug14: now in 6 practices – the project to learn from) getting referrals from 5. Some Stake- RED – problems identified AMBER – actions and review GREEN - outcome holder confusion re PCAL still Patients Nov-13: no self referrals, much Aug-14: no self referrals, but Sept-14: project is live with uncertainty when patients growing interest from patients, steady stream of patients being arrive at appointments about understanding when attend seen why they are there, what service is and is expected of them. LC observation of case workers Reported by case workers at Project data base in practice including mini project meetings interviews with staff. Project meetings A AIW Nov-13: staff training needs April-14: have recruited new Sept-14: case workers ready to C identified from LC observation - case worker. Have started deliver training to others at T not offering distinct regular supervision for case planned GP event (was I intervention, rather AIW care. workers. Case workers engaged postponed to January 2015) O Need for ongoing clinical in evaluation work – in N supervision identified defining/describing the Dec-13: loss of one case worker, intervention (supporting own urgently need replacement practice) Practice Sept-13: GPs not recognising May-14: have produced Case workers report that GPs Team that there is a role for them in practice/professional and starting to recognise an doing things differently patient leaflets that help people alternative approach. To follow in using BB approach in to phase 2 Patients Sept-13: patients arriving with Identified need for GP training Case workers report patients little understanding of their role event being planned for Sept 14 working well with the BB in care process model. To formally evaluate in phase 2 (case studies) LC observation including Case Studies. Project team meetings including with practice staff M AIW Project meetings: feedback of For phase 2 O NPT traffic lights N Practice Case workers feeding back at For phase 2 I Team Not really happening yet except practice meetings T through project meetings O Patients Patients reflecting back during For phase 2 R follow up appointments I N Project meetings and the NPT traffic lights G

In italics = data source

BB = BounceBack. PCAL = another AIW Health commissioned service to provide debt advice in a GP setting