Improving service approaches and outcomes for people with complex needs through consultation and involvement

Services have not always catered well for people with complex needs. The term 'complex needs' is used here to signify people who have cognitive impairments and communication difficulties that present major challenges for getting one's views and preferences heard and understood, and/or who may not fit into traditional categories of service provision. Current developments in policy and practice, such as the single shared assessment process, emphasise inclusion through user involvement. There is a danger, however, that people with complex needs will be seen as too difficult to involve, and will therefore remain effectively excluded from the decision-making process and from the opportunity to influence service provision. This article explores the current situation in relation to ensuring genuine involvement for people with complex needs, highlights obstacles to progress and examples of good practice, and identifies future directions for research and practice.