What is complex care and why is there an increased focus in this sector?
Introduction
The blog delves into the fundamentals of complex care, detailing its definition, the conditions it addresses, and the reasons behind its growing importance.
It investigates the increasing demand for complex care services, then addresses the challenges faced by healthcare providers and the NHS in meeting this demand – and how it may be overcome.
Contents
- What is Complex Care?
- Who delivers complex care?
- Why Is There An Increased Focus on Complex Care?
- How Complex Care Providers Can Manage the Increased Demand
What is complex care?
Complex care, also known as continuing care, is specialised healthcare support for people with chronic or long-term health conditions who need help managing their symptoms and daily tasks.
As well as the medical aspect of complex care, its function is to support patient’s dignity and independence through compassionate, person-centred care.
What needs are considered complex?
Complex care needs are long-term, progressive conditions, illnesses or injuries. These may be mental or physical.
Unlike general domiciliary care, complex care involves medical intervention or nursing care from trained professionals.
There’s no set length of time that an individual may require complex care services. If a person has been treated in hospital and discharged to continue recovery at home, they may only require complex care for a few weeks. For people living with chronic, long-term conditions, complex care support may last years, or for their entire life.
What are examples of patients with complex care needs?
Serious Illnesses and chronic conditions are not ageist – from new-born babies to the elderly, complex care can, unfortunately, be required at all stages of life.
The exact type of complex care given to a patient varies depending on their individual and unique needs.
Examples of complex care conditions:
Neurological Conditions
- Multiple Sclerosis (MS)
- Parkinson’s Disease
- Motor Neurone Disease (MND)
- Cerebral Palsy
- Epilepsy
- Traumatic Brain Injury (TBI)
- Stroke
Genetic and Rare Conditions
- Cystic Fibrosis
- Huntington’s Disease
- Ehlers-Danlos Syndrome (EDS)
- Spinal Muscular Atrophy (SMA)
- Sickle Cell Disease
Mental Health and Cognitive Disorders
- Dementia, including Alzheimer’s Disease
- Severe Learning Disabilities
- Autism Spectrum Disorder (requiring high-level support)
- Schizophrenia or severe mental health conditions
Complex Physical and Sensory Disabilities
- Spinal Cord Injuries
- Limb Loss or Amputation with secondary health complications
- Sensory Impairments (eg, dual sensory loss with related challenges)
Palliative and End-of-Life Care
- Advanced Cancer with palliative needs
- End-stage organ failure (heart, lung, liver)
Paediatric Complex Needs
- Neonatal conditions requiring long-term care (e.g., prematurity with complications)
- Severe congenital abnormalities
- Children with long-term ventilation needs
Due to the nature of chronic, progressive, or multifaceted conditions, one constant with complex care is the need for specialist, multidisciplinary healthcare management.
Caring for someone with complex care needs requires expert carers who are proficiently trained in specific care techniques. This may include PEG feeding, gastrostomy care, oxygen therapy, or other specialist care methods.
A complex care plan, or package, is developed from assessing the requirements of the individual. As well as medical requirements, the plan should cover steps to ensure the person is able to remain as independent, comfortable and physically healthy as possible. Good complex care is holistic care.
“Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”
—the World Health Organization
In terms of wellbeing and general health, the following will be considered as part of a complex care package.
- Nutrition: preparing and serving healthy, nutritious meals, and assisting with feeding where required.
- Mobility: keeping the person stimulated and as active as possible, which is, especially important for those with restricted mobility.
- Cleanliness: this can include routine washing, dental care, haircare and other hygiene practices.
- Continence: assisting with any continence aid and maintaining bowel and bladder care.
- Emotional support: providing companionship and sensitive compassionate assistance
- Community and social engagement: assistance with opportunities to engage in social activities such as visiting family, shopping trips, or attending appointments as required
Who delivers complex care?
Complex care is usually provided to individuals by a team of healthcare professionals. These healthcare professionals work collaboratively to ensure that patients receive efficient, precise and tailored care in a home setting.
Healthcare professionals involved in delivering complex care in patients’ homes typically include:
- Registered Nurses
- Community Nurses
- Specialist Nurses (eg, for palliative care, respiratory care, or neurological conditions)
- RSCN – Registered Sick Child Nurses
- Healthcare Assistants (HCAs)
- Trained to assist with daily living activities, personal care, and some clinical tasks
- Allied Health Professionals (AHPs)
- Physiotherapists (for mobility and rehabilitation support)
- Occupational Therapists (to adapt home environments and promote independence)
- Speech and Language Therapists (for swallowing or communication needs)
- Dietitians (to manage nutrition and feeding plans)
- General Practitioners (GPs)
- Often provide oversight, prescribing medications, and managing ongoing health conditions.
- Clinical Pharmacists
- To assist with medication reviews and management in coordination with other care providers.
- Palliative Care Teams
- May include a mix of nurses, doctors, and support staff specialising in end-of-life care.
- Social Care Workers
- Provide non-clinical support with day-to-day activities and emotional wellbeing.
- Specialist Support Workers
- Trained to assist patients with specific needs, such as mental health or learning disabilities.
- Care Coordinators
- Often manage the overall care plan, ensuring different professionals work together effectively.
Why Is There An Increased Focus on Complex Care?
The impact of an increasingly ageing population
The UK has a rapidly ageing population, in part due to dramatic improvements in life expectancy since the turn of the 20th century. Effective public health measures such as childhood immunisations, the introduction of universal health care, and medical advances in treating adult diseases such as heart disease and cancer, have all contributed.
In more recent years, more rapid technological advances and positive lifestyle changes (including a decline in smoking) have helped to increase life expectancies even further.
In 1960, the life expectancy of females was 73.8 years, 68.1 for males. Up to 2022, this increased to 82.8 and 78.8, respectively – an incredible rise for such a relatively short period.
But although factors like positive lifestyle changes and better healthcare support are contributing to longer life expectancies, that doesn’t mean people are necessarily living healthier longer lives.
For that 78.8 years expectancy for males, the average healthy male life expectancy was only 62.4 years. In other words, 16.4 of those years (21%) would have been spent in poor health. For females’ life expectancy of 82.8 years, 20.1 years (24%) would have been spent in poor health.
Similarly, disability-free life expectancy is almost two decades shorter than life expectancy, and is higher among males (61.8 years) than females (60.5 years).
Life expectancy is increasing, but healthy life expectancy is not increasing at the same rate.
“Although the average health of older people is improving, the rapid increase in the number of older people still means a substantial increase in the number of individuals requiring care.”
—The longevity society | Prof Andrew J Scott
By 2035, the number of adults aged 85 and over who require 24-hour care is expected to reach 446,000 – almost double the current figure.
And according to the Office of National Statistics, nearly half of the UK population already lives with a chronic or long-term health condition, impacting 50.1% of women and 45.7% of men.
This data suggests that while we have the means to extend our lives, we don’t yet have the means to sustain the quality of our lives. The result is a higher and increasing need for complex care support.
NHS Funding Pressures
The NHS faces increasing financial pressures, so home-based settings can provide a cost-effective alternative for delivering complex care, reducing the need for expensive hospital stays. Supporting a reduction in unnecessary hospital admissions also frees-up the NHS’s capacity to manage acute and emergency care requirements.
This growing emphasis on providing care in community settings rather than hospitals is not just about financial and capacity pressures though.
Many people prefer to be treated at home if possible, rather than in hospital – as long the level of care is comparative. So, driven by the goal of improving quality of life for individuals with complex needs, it can also offer more positive circumstances and outcomes for patients, as well as the National Health Service.
How Complex Care Providers Can Manage the Increased Demand
For complex care providers and local authority teams, navigating increased demand, workforce shortages and operational pressures, is a multifaceted challenge that cannot be dealt with alone.
Delivering complex care has always required a multidisciplinary, holistic approach, and now more than ever, the need for strong communication, collaboration and support is paramount.
“Having the right numbers and skill mix of community staff is essential to providing high-quality care, keeping people well in their own home or in the community, and reducing additional demand on acute hospitals and other healthcare services.”
— There is no community without people | NHS Confederation
At ID Medical, we understand the specialist requirements and diverse clinical expertise that continuing care often requires in home settings, which is why we offer flexible and rapid complex care staffing solutions, tailored to your needs.
We have proven capability of mobilising HCPs within hours – for ad hoc supply and for urgent/last-minute fulfilment requirements. Well-matched CVs can be provided within one day, shadow shifts can be arranged within a few days, and we can supply HCPs for complete, longer-term care packages within a week.
Whether you need contingent support to address immediate needs or long-term support to maintain continuity, we specialise in providing tailored staffing solutions efficiently and at speed.
- Rapid staffing solutions: Access a pool of 100k+ Healthcare Professionals for short- and long-term needs
- Specialist expertise: Skilled professionals experienced in managing complex clinical and personal care requirements
- Operational efficiency: Streamlined processes for swift and efficient mobilisation
And with over 20 years of healthcare experience, we are trusted partners to organisations across the UK.
Want to find out more about how ID Medical can help?