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A method of fashioning needs‐led and evidence‐based services on a multi‐agency basis is described. The approach is based on research but is designed for application by professionals and users in agency settings. Its strengths and weaknesses and application on an international scale are discussed, using examples from provision for vulnerable children and families.

Needs led person centred services are the hallmark of high quality intellectual disability services. Commissioning mechanisms such as Payment by Results (PbR) have been established in acute health services. An outcome focussed version of PbR will be implemented nationally from 2012 in an incremental manner in mental health services for adults and older people. Though intellectual disability services are currently excluded, it is proposed that needs led approaches would improve the quality and efficiency of specialist intellectual disability services. This paper aims to suggest that this approach could be the key to commissioning and designing personalised pathways of care.

Health needs are scoped and care pathways are defined as primarily consisting of Needs, Interventions and Outcomes. The mandated cluster groups to be used for PbR in adult mental health and older people's services are extended to cover the non overlapping needs of people with intellectual disability to provide an integrated framework of health needs usually met by specialist services. A framework of interventions is suggested and components of “assessment” and “therapeutic” activities are outlined. An outcome framework is described. A case example illustrates the application of these components to design a care pathway to provide a personalised, needs led service.

It is possible to use the principles underlying PbR to commission personalised services of high quality, improved efficiency and thus greater value.

The principles underlying PbR can be used to commission personalised pathways of care in intellectual disability services at a time when this approach is being extended to mental health services nationally.

There has been limited evidence on which to base services in the community for people who have intellectual disabilities and coexisting mental health problems. Recent research involving service users, carers and professionals has identified a number of key service components that community services should provide. More detail is needed to explore how best these components could be implemented and delivered. This paper aims to discuss these issues.

A total of 14 multidisciplinary professionals from specialist intellectual disabilities services in the UK were interviewed about their opinions on four key areas of community service provision. These included the review and monitoring of service users, their access to social, leisure and occupational activities, the support, advice and training around mental health for a person's family or carers and “out of hours” and crisis responses. The interview data was used for coding using the NVivo 7 software package and then analyzed using thematic analysis.

Analysis of participants' views on these key essential service components produced wider themes of importance. The ten major emergent themes for services were: their configuration/structure, their clarity of purpose/care pathways, their joint working, their training, their flexibility, their resources, their evidence‐base, being holistic/multidisciplinary, being needs‐led/personalised and providing accessible information.

These views of experts can help inform further research for the development and the evaluation of services.

Children's services agencies in England are increasingly expected to work together to plan needsled interventions in their locality. Such planning requires good information on local need and service take‐up, yet this is often lacking. Connecting data from single agency, multi‐agency and community studies in one district shows how the severity of need overlaps with different service and administrative categories. The findings point to the value of such mapping exercises, while the pattern that emerges highlights the importance of planning provision for all children and of linking intervention to thresholds of severity of need. The approach will have relevance to other care groups.

Experience has shown that states lose business and stall the ensuing development of their economies because of a lack of quality and foresight in their education systems. Some states feel that they have a vast reservoir of unskilled citizens who will work for nothing and companies will buy into it, but Harlan Cleveland in his article, “Education for Citizenship in the Information Society,” writes that “people who do not educate themselves, and keep re‐educating themselves to participate in the new knowledge environment will be the peasants of the information society.” Many research libraries are also stunting their own development through a lack of foresight in the provision of service. These libraries feel that their “all‐encompassing” unconnected collections continue to be a drawing card for recruiting and retaining the best scholars. University administrators who are also strategic planners will not continue to financially support this attitude.

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.

The purpose of this paper to synthesise much of the existing research on autistic spectrum disorder (ASD) and offending behaviour.

It considers three key areas, namely, first, a discussion about the nature of ASD and how it might be related to offending behaviour; second, a brief commentary about the prevalence of this population; and, finally, an exploration of the effective management and possible treatment outcomes.

Methodological limitations have resulted in variable findings which has hindered our understanding of this population. Some of the research is based on small, highly specialist samples making prevalence difficult to measure. The link between ASD and offending is still not well understood, and despite advances in staff training, awareness amongst practitioners remains an underdeveloped area, thus yielding variable treatment outcomes.

This review continues to demonstrate the urgent need for robust research in order to better understand the link between ASD and offending behaviour, to provide tailored, needs-led interventions, and reduce the risk of offending amongst this group as a whole.

The author looks back on a series of articles published since 1996 in this journal, and concludes that the evidence points to the likelihood of continuing difficulties in implementing national policies at local level. The impact of New Labour approaches to community care is considered.