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This overview paper brings together themes that are more commonly treated in isolation; in addition, there is hitherto unpublished material on the CPA, and illustration with examples of contemporary developments.
