Search results

Too many health and social care services are failing to meet people's complex needs. In this paper, ‘complex needs’ is presented as a framework to help understand multiple interlocking needs that span health and social issues. The concept encompasses mental health problems, combined with substance misuse and/or disability, including learning disability, as well as social exclusion. The paper outlines a strategy for promoting the well‐being and inclusion of people with complex needs. At the heart of this strategy is a new kind of delivery model: connected care centres, a type of bespoke social care service, a model which has been endorsed by the Social Exclusion Unit (SEU). In addition, the paper describes how new responses from existing services can promote better support for people with complex needs, such as a reformed commissioning process and a new ‘navigational’ role for the social care worker.

This article focuses on people with complex needs and the impact of Valuing People and Valuing People Now on improving their lives and opportunities. It considers the current situation and challenges, where most people with complex needs have experienced disadvantage and have not seen as much improvement in opportunities as others. Health needs are covered elsewhere in this journal, and so this article looks at the remaining priorities in Valuing People Now: housing and employment. The key issues are explored and the Sustainable Hub for Innovative Employment for People with Complex Needs, established as a result of the Valuing People Now employment work, is described. It explores the lessons learnt so far and the challenges faced, with a summary of the next steps.

This paper aims to describe how public librarians can better address complex information needs. First, librarians should classify the degree of complexity of the need by using Warner’s classification model; then they can use Popper’s three world theory to anticipate and respond to complex information needs by following specific steps.

After examining the information science literature, appropriate models were selected to support public librarians. Our information science scholarship, coupled with our practical experience, informed our search and selection.

This paper details specific steps that public librarians can take to anticipate and respond to individual information needs. Doing so is imperative as the information needs of the public continue to become increasingly complex.

This paper improves information practice because it offers specific steps to aid public librarians to anticipate and respond to complex information needs. It draws upon an existing model and theoretical framework. This paper also highlights selected examples of how public librarians across the USA have anticipated information needs, and developed partnerships with organizations external to the public library to address complex information needs.

The purpose of this paper is to examine music as a therapy for complex needs and offending behaviour.

This study utilised the rapid evidence assessment (REA) approach to collect and assess the current data pertaining to music as a therapy for complex needs and offending behaviour. Within the REA this study used a thematic analysis as the analytical framework to manage and explore the wealth of data collected during the REA.

The results of this study are presented in two parts – first, the application of music as a therapy for complex needs and second, music as a therapy for offending behaviour. These two sections explore music therapy as an effective intervention method for offending behaviour and/or complex needs. Psychopathy as a complex need is a subsidiary theme that is also investigated within this section.

To present music as a therapy as an effective method of therapy and intervention for those with offending behaviour and/or complex needs, thus, leading to further research in the field.

To incorporate music therapy into working with offending behaviour; to incorporate music therapy into interventions for those with complex needs, such as psychopaths; to recognise a need for developing innovative approaches/methods to address gaps in treatment; and to recognise music therapy’s potential as a programme utilised alongside cognitive-behavioural therapy.

There has been a significant amount of academic attention given to researching music as an effective therapy for select groups such as those with autism, anxiety, dementia and depression. The scope of this attention has extended to examine the link between music, cognition and emotion. The limitation of this work is the lack of research that has focussed on music as a therapy as an intervention for complex needs and offending behaviour, to which this study will begin to redress.

The purpose of this paper is to conclude a two-part review of past and current approaches to meeting the more “complex” needs of individuals in the UK context. It explores the dilemmas of commissioning, the development of personalisation approaches in funding or care planning mechanisms, the need to address power relations and lessons from the introduction of the role of a “lead professional” in the Care Programme Approach (CPA), concluding with the development of more systemic approaches at locality level.

This, being the second of two papers, extends the historical narrative approach of Part 1 to the analysis of the term “complex needs” and its role in contemporary service delivery.

The first responsibility of services has been to find ways to engage these more “at risk” individuals and their needs more effectively; and innovation and guidance on this is valuable. But the paper also needs to address the nature of the net itself, that lets so many through. Reliance on individuating mechanisms of service delivery to respond to individual complexity may be less effective in tackling complex needs, unless accompanied by more effective collective representation, and systemic change.

This overview paper brings together themes that are more commonly treated in isolation; in addition, there is hitherto unpublished material on the CPA, and illustration with examples of contemporary developments.

This article describes the changes in the population of people with learning disabilities in Sheffield and the associated demand for specialist learning disability services, primary and acute health services and the wider public realm. It comments particularly on people with the most complex needs. The study to produce this data was in two parts: an analysis of changes in the overall number of people with a learning disability which included a projection of how the number might change over the next ten years, and an analysis of the health and support needs of young people with profound and multiple learning disabilities (PMLD), and how these might change in the future. The findings are compelling. The overall number of people with a learning disability in Sheffield increased by 25% in the 10 years from 1998 to 2008, the number of children and young people with a learning disability increased by nearly 120% and young people with PMLD were found to have an unprecedented level of health and social care need, which will increase further as they enter adulthood. The implications of the findings are discussed and suggestions for further research are offered.

This paper – the first of two – aims to trace the origins of, and suggest the underlying intentions behind, the recent appearance of the new term “complex needs”, amongst commissioners, service providers and some service user groups.

The paper takes a narrative approach, describing the early appearance of the term “complex needs” in services for those excluded from and/or stigmatised in mental health services. This is then contextualised with UK Government policy papers.

Contemporary usage of the term “complex needs” may at times be inconsistent and confusing; but it reflects government concerns that service provision has become too narrow in focus, and less needs‐led. The concept embodies an implicit critique of overly narrow practice, and holds the prospect of more systemic change.

“Complex needs” is relatively new, as a quasi‐technical term; as is any analysis locating its usage in the context of current overly narrow service definitions.

Improvements in neonatal and paediatric care mean that many children with complex care needs (CCNs) now survive into adulthood. This cohort of children places great challenges on health and social care delivery in the community: they require dynamic and responsive health and social care over a long period of time; they require organisational and delivery coordination functions; and health issues such as minor illnesses, normally presented to primary care, must be addressed in the context of the complex health issues. Their clinical presentation may challenge local care management. The project explored the interface between primary care and specialised health services and found that it is not easily navigated by children with CCNs and their families across the European Union and the European Economic Area countries. We described the referral-discharge interface, the management of a child with CCNs at the acute–community interface, social care, nursing preparedness for practice and the experiences of the child and family in all Models of Child Health Appraised countries. We investigated data integration and the presence of validated standards of care, including governance and co-creation of care. A separate enquiry was conducted into how care is accessed for children with enduring mental health disorders. This included the level of parental involvement and the presence of multidisciplinary teams in their care. For all children with CCNs, we found wide variation in access to, and governance of, care. Effective communication between the child, family and health services remains challenging, often with fragmentation of care delivery across the health and social care sector and limited service availability.

As the social care system ‐ and potentially the health care system and other public services ‐ move increasingly towards a model of personalised support, questions arise about whether and how it can work for people with multiple and complex needs. The evidence is that it is possible to achieve this, and that the outcomes and quality of life can be dramatically improved, but many councils and their partners have yet to move into this demanding activity, and face considerable obstacles in the form of conventional approaches to policy and practice if and when they do. This article draws on the findings of a special study undertaken for the Commission for Social Care Inspection. Alongside some of the difficulties of personalising support for people with multiple and complex needs are inspirational stories of innovative developments which have transformed the lives of people and their carers.

Valuing People Now (DH, 2009) recognises that some people, particularly those with complex needs, have been missing out. It has made ‘including everyone’ a priority for the next three years. With reference to Tom's story, this paper will consider the reasons why people with profound and multiple learning disabilities (PMLD) remain among the most marginalised people in society today, what has changed since Valuing People (DH, 2001) and what needs to change in the next three years of delivering Valuing People Now (DH, 2009) if we are to rise to the challenge of ‘enabling extraordinary people to live ordinary lives’ (McConkey, 1998).