The formation of Complex Care Teams (CCTs) targeted at people with complex health and social care needs
Watch a DVD about a complex care team
Adults and their carers coping with a long-term condition and/or complex needs will receive improvements in the way they are supported due to plans being put into place to bring together professionals from health, social care and the voluntary sector to work together better.
The National Policy Framework Our Health, Our Care, Our Say states that: ‘By 2008 we expect all Primary Care Trusts and local authorities to have established joint health and social care managed networks and/or teams to support those people with long term conditions who have the most complex needs.’
Devon County Council, Devon Primary Care Trust and Northern Devon Healthcare Trust alongside primary care are now working towards the integrated service delivery of adult services. This will enable the outcomes by ‘Our Health, Our Care, Our Say’ to be delivered successfully but more importantly it will ensure that the care and support received by older people and their carers is centred on the person.
Older people who need a home visit or a face to face assessment will be looked after by new complex care teams made up of health and social care staff based in market and coastal towns near to where people live. These staff will work together with the support of specialists to provide better health and social care support close to home helping people to be stay independent for as long as possible.
The complex care teams will be linked to GP practices across Devon to provide people with expert advice and the best resources to ensure the delivery of the right care, at the right time, in the right place. They will also work with their GPs to identify people at risk of loss of independence or unnecessary admission to hospital and work together to help prevent people falling into crisis.
There will be improved communications between health and social care professionals who will use joint assessment and care planning processes and a shared IT system which will mean that people will only have to provide their details once.
There will be 23 complex care teams that will work within 16 clusters across Devon Most clusters will have one complex care team but some larger clusters will have two. Clusters are integrated health and social care services grouped together alongside primary care services for GP practice populations within designated geographical areas. Clusters will include services such as local community hospitals, some core community nursing services and some specialist NHS or social care services. Map showing the CCTs and the main towns in Devon.
There is already good local evidence of integrated working in place across Devon and we plan to build on this existing good practice. The completion of the implementation of complex care teams will be May 2009.
Some frequently asked questions and their answers.
Complex Care Teams
