Service developments for managing people with long-term conditions using case management approaches: an example from Cheshire in the UK

INTRODUCTION: This research was part of a wider Innovation Forum (IF) research project which was an initiative to improve services and bring about a 20% reduction in the unscheduled use of acute beds by older people (aged over 75) through a range of initiatives. This research considers the developments made in the provision of services for long-term conditions. AIMS AND OBJECTIVES: The research has investigated the development and implementation of case management for people with long-term conditions by community matrons within one IF pilot site. METHODS: Semi-structured qualitative interviews and action learning events were held with service leads and community matrons at baseline and repeated one year later. Participants were invited to raise and update issues on development, operation and provision of services for people with long-term conditions. RESULTS: The development of case management provides key lessons for service development. Continual system and role change has had implications for service delivery, whole system including integration of care, infrastructure, capacity and routine evaluation. CONCLUSIONS: There is a need for case management to be consolidated within a wider system of services. Impacts and outcomes of case management roles need to be demonstrated with systematic and routine evaluation of patient outcomes.