In answer to requests from commissioners, we offer three handbooks which provide practical support for good long term condition management. They set out the required service components and draw on the latest research, best practice and case studies to show how this can be done. The handbooks are useful to both clinicians designing services, and commissioners.
- Case finding and risk stratification – identifying cohorts of people with long term conditions who are most vulnerable and/or will benefit most from tailored care and support. Next Steps for Risk Stratification in the NHS – aimed at stakeholders, discussing next steps for risk stratification within the NHS.
- Personalised care and support planning – enabling commissioners and health care practitioners to deliver personalised care. The updated handbooks have been jointly developed with the Coalition for Collaborative Care.
- Multi-disciplinary team (MDT) working – supporting health and care professionals to work across professional and organisational boundaries.