Challenges in delivering personalised support to people with multiple and complex needs: qualitative study.

Area of Science:

• Social Sciences
• Health Services Research
• Public Policy

Background:

• Personalisation in service provision aims to center individuals' needs, hopes, and goals.
• This study examines a well-resourced program offering personalised support and personal budgets to individuals with multiple and complex needs.

Purpose of the Study:

• To identify challenges in delivering personalised support to beneficiaries with multiple and complex needs.
• To share learning from a programme that struggled with beneficiary recruitment and retention.

Main Methods:

• Repeat semi-structured interviews were conducted with 56 beneficiaries, programme workers, and external partners.
• Interview data were audio-recorded, transcribed, coded, and analyzed using Iterative Categorization.

Main Results:

• Five categories of challenges were identified: poor programme understanding, beneficiary/worker characteristics, budget ownership ambiguity, strained interprofessional relationships, and excessive bureaucracy.
• Interacting individual, organizational, and system-level factors, especially poor interprofessional collaboration, compromised person-centred support delivery.
• Personal budgets may inadvertently undermine personalisation for individuals with multiple and complex needs.

Conclusions:

• Effective delivery of personalised support for complex needs requires addressing individual, organizational, and systemic factors.
• Improving interprofessional collaboration is crucial for successful personalised support programmes.
• The implementation of personal budgets needs careful consideration to ensure they enhance, rather than hinder, personalisation for vulnerable populations.