ABSTRACT
This chapter examines the evolution of care management in services for older people as one of the fundamental components of community care reform in the United Kingdom (UK). Hospital discharge requires a different from of coordinated response to long-term care management, involving for many older people short term intensive response and rehabilitation. The development of care management arrangements in UK social services has principally taken place following the full implementation of the National Health Service and Community Care Act in 1993. The Personal Social Services Research Unit evaluations of intensive care management examined both social care and joint health and social care approaches to care management. Care management systems devised in agency isolation and lacking access to appropriate expertise for assessment are unlikely to be fully effective, particularly when dealing with individuals with complex problems. Information systems available for care management have been criticised for being rudimentary, and local systems of performance review are necessary for effective management.
