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Case management: What it is and how can it be implemented?

Nick Goodwin introduces our new paper on case management, evaluating practical examples and considering how it can help establish integrated health and social care.

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Case management: What it is and how can it be implemented?

  1. 1. Case managementWhat it is and how can it be implemented?Dr Nick GoodwinSenior Fellow, The King’s Fundwith thanks to Shilpa Ross and Natasha Curry
  2. 2. What is it? An approach to caring for people with long-term conditions (LTC) Usually nurse-led community-based programmes Components include: – case finding – assessment – care planning – care co-ordination – case closure
  3. 3. Why is it important? Share of budget for people with LTCs Co-ordinates and integrates services Enhances the patient experience Improves care outcomes Reduces expensive care service utilisation
  4. 4. The benefits Impact − ‘promising but mixed’ Works best when part of a wider programme of care
  5. 5. Case example: Guided care Specially trained nurses integrated into primary care practices Predictive modelling techniques identify at-risk patients Nurse undertakes assessment of patient and carer needs and co-designs an action plan Nurse supports case load of 50-60 patients, provides self-management support and co- ordinates care across agencies Secure web-based electronic health record supports real-time decision-making
  6. 6. Case example: Guided care 2 Positive outcomes: – high levels of satisfaction amongst patients, carers and professionals – significant improvements in quality of care – reduction in total health care costs of 11% See:
  7. 7. Key factors for success Appropriate roles and skills of the case manager – assigned accountability – clarity of responsibilities – a range of skills – relationship building Getting the programme design right – targeting and eligibility – manageable caseload – single point of access – continuity of care – effective use of data/IT
  8. 8. Support from the wider system Shared vision and objectives Close links between health and social care Stakeholder engagement Provision of services in the community
  9. 9. Conclusions Potential to deliver better care for patients and reduce costs But, evidence shows it has not always worked Good case managers and care teams needed in a co-ordinated, care provision system Must be delivered as part of a wider programme approach