Safe Care for Adults with Complex Health Needs
About this PSP
This PSP focused on safe care for adults with complex needs (such as those who have more than one illness or disease or condition or disability). People with complex health needs will potentially need care from a range of services and settings, including primary care (e.g. GPs), secondary care (e.g. hospitals), community health services, mental health services, and social care either at home, in a care home or nursing home. Their care will evolve over time and typically become more complicated as time passes.
Many healthcare providers have a good track record in providing safe care. However, too many patients continue to be harmed by avoidable mistakes in their care that could be prevented. Our understanding of the problems and what might help healthcare providers and patients has greatly improved over recent years, but there are still many unanswered questions. This PSP identified the Top 10 areas that need research to make care safer for adults with complex health needs, by asking patients, carers, the public and healthcare staff about what their unanswered questions are and prioritising them.
This PSP was run by the National Institute for Health and Care Research Imperial Patient Safety Translational Research Centre.
See a news report about the PSP results.
The Safe Care for Adults with Complex Health Needs PSP Top 10 was published in January 2019.
Video announcement of the Top 10
Top 10 Priorities
- When people with complex health needs require care from more than one specialist or department, how can their needs be addressed in a way that considers the whole person through better organisation and team-working?
- How can communication be improved amongst professionals working in different organisations who are involved in the care of a person with complex health needs?
- How can health professionals be encouraged to listen to and value the expertise of people with complex health needs, in relation to treatment and management of their health condition(s)?
- How can we ensure that people with complex health needs are discharged safely from hospital, in a way that ensures their individual treatment, support and care needs will be met? How can we ensure that all of the services involved are committed to this?
- How can communication be improved amongst the health professionals within a single organisation who are all involved in the care of a person with complex health needs?
- When people with complex health needs receive care from different specialists, should one health professional oversee that person's treatment and care to improve safety?
- How can important information about a person with complex health needs be recorded in a way so that health professionals can access the key facts quickly?
- How can health and social care be better joined up, more flexible and responsive, so that a person with complex health needs can be regularly reviewed and their care plans changed as necessary?
- How can (paid and unpaid) carers’ knowledge of a person with complex health needs and their specific healthcare needs be recognised and used to improve and inform the care provided by professionals?
- To what extent do health professionals read patients' medical records before providing care to people with complex health needs? How can this be improved?
The following questions were also discussed and put in order of priority at the workshop:
- How can health professionals be made aware of how a person's pre-existing condition(s) might affect the outcome of treatment for another condition?
- Following treatment in hospital or from a GP, should people with complex health needs be followed up to ensure their treatment and care continues to be safe, and who should be responsible for this?
- How can the NHS better meet the needs of people with a learning disability or autism when providing general care?
- After hospital discharge, how quickly are any changes to care and medication for people with complex health needs communicated to other professionals involved in their care (e.g. GPs, pharmacists, paid carers)? How can this communication be improved?
- How can diagnosis of a new condition be improved for people with complex health needs, when health professionals may assume that all symptoms are due to a pre-existing condition?
- Does seeing the same health professionals (GP, paid carer or hospital consultant) over time improve the safety of care for people with complex health needs?
- When unpaid carers provide support to people with complex health needs in hospital, how can the carers themselves be supported and the care they provide be valued by professionals?
- How could health professionals use hospital passports for people with complex health needs more effectively (a hospital passport explains how a person with special needs likes to communicate as well as their support needs)?
- How can people with mental health problems be better supported if they experience distress and anxiety when they need to go to hospital for general care?
- How well do NHS staff understand the difficulties faced by unpaid carers of people with complex health needs when the carer needs to organise or receive treatment themselves? How well does the NHS help these carers to manage their caring responsibilities?
- How can safe care be assured for people whose behaviour resulting from their condition may be perceived as challenging by healthcare professionals?
- Would a care co-ordinator (someone who organises appointments, blood tests etc.) improve the safety of the care of people with complex health needs?
- How can medicines be given safely to people with complex health needs who have difficulty swallowing medicine?