Scottish Government

Dr Ann Rosengard and Isla Laing (Ann Rosengard Associates)
Dr Julie Ridley (Ridley Kirk Consultancy)
Susan Hunter (University of Edinburgh)
ISBN 978 0 7559 6413 0 (Web only publication)
This document is also available in pdf format (816k)

C ontents

Acknowledgements

Executive Summary
Study aims
Methodology
Key findings
Good practice and lessons for implementation

Chapter One: Introduction
Background
Aims and objectives
Research method
The scope and limits of the study
Structure of the report

Chapter Two: Who has multiple and/or complex needs
Introduction
Complex terminology and mutliple issues
Emergent policy concerns and priorities
The prevalence of multiple needs
Summary
Key points - Chapter Two

Chapter Three: Awareness of and access to services
Introduction
Constraints on awareness
Barriers to access
Key points - Chapter Three

Chapter Four: Experiences of services
Introduction
Experiences of care and support
The context of transitions
Unsettled pathways, fragile solutions
Non-engagement, exclusion and low participation
User involvement
Outcomes
Key points - Chapter Four

Chapter Five: Summarising the gaps
Introduction
The gaps
What do people with multiple and complex needs want from services?
Key points - Chapter Five

Chapter Six: Improving practice and opportunities
Introduction
Increasing awareness of services
Improving access through creative targeting and flexibility
Improving the experience of service provision
Negotiating fragmented services
Increasing service user involvement and control
Ensuring smooth transitions
Service outcomes
Joint working
Targeting services and resource issues
Service principles
Key points - Chapter Six

Chapter Seven: Conclusion and implications
Introduction
Comment on the research
Addressing the gaps and deficits
Implications - improving the response
Concluding points

References and sources

Appendix One - Other perspectives on 'multiple' and/or 'complex' needs

Appendix Two - Prevalence rates for people with more than one service need

Appendix Three - Other examples of good practice
Information provison
Improving access to services
Improving social and health care through planning, joint work and participation

List of Tables
Table 1.1. List of main databases and indexes sourced for the literature review
Table 3.1. Awareness, experience of access and service implications
Table 4.1. Influences on experiencing services and good practice implications
Table 7.1. Summary of good practice - working with people with multiple and complex needs

The views expressed in this report are those of the researcher and
do not necessarily represent those of the Department or Scottish Ministers.