Care and support for people with complex and severe needs: innovations and practice. A scoping study

SPRU research team

Related links

Publications and presentations from the project are available from the York Research Database

Complex Needs summary (PDF , 179kb)

External collaborators

  • Jenni Brooks, Department of Psychology, Sociology and Politics, Sheffield Hallam University



People with complex and severe needs constitute a relatively small proportion of all adult social care users. However, they are growing in number, and meeting their needs can be problematic for service commissioners and providers. In particular, they often need personalised, co-ordinated and specialised services from a wide range of providers, which can be difficult and costly to deliver.


This scoping study identified:

  • key features of the service and support arrangements desired by different groups of disabled adults and older people with severe and complex needs
  • evidence of initiatives to deliver support to disabled people with complex and severe needs that have the desired features and the potential to constitute examples of ‘good practice’. Examples included the different levels of commissioning, operational organisation and front-line delivery.


The study involved:

  • consultation with key stakeholders, including organizations of and for service users and carers, on the desired features of good support and service arrangements
  • a review of recent published and grey research on relevant service developments and initiatives
  • case studies of ten examples of good practice in service provision or commissioning, identified through the above two stages.

These detailed descriptions provide an invaluable starting point for the future evaluation of service models.

Policy and practice aims

The study aimed to generate evidence to inform social care practice in commissioning and providing support to people with complex and severe needs, in accordance with those service features that are highly valued by users and carers themselves. There was a particular focus on the role of social care in co-ordinating or collaborating with other providers over the commissioning, organisation and delivery of services; and on identifying examples of good practice that have the potential to be transferrable to other similar groups of service users. Summaries of the study findings were disseminated widely to all English adult social care departments, NHS primary care trusts and relevant voluntary sector organisations. The results of the study were also disseminated through NIHR School for Social Care Research knowledge transfer activities.

Research findings

This project is now complete and publications from it are available below, along with details of presentations made by the team.

Ten case studies of examples of potential good practice, identified through the consultation process in the project, are also now available for you to download.

Additional information

Related links

Publications and presentations from the project are available from the York Research Database

Complex Needs summary (PDF , 179kb)