The Art of Stuck Cases: A Framework for Managing Complexity in Primary Care

Primary Care Knowledge Boost

Doctors Lisa and Sara talk with Consultant Psychiatrist Dr Mark Spurrell about a framework that can be applied to the care of complex patients with multiple problems or difficulties. It is particularly useful at times where we feel stuck, we are struggling to help or move forward and care may be fragmented with lots of care professionals feeling similarly. The idea is to use a value based approach using the whole team to breathe new life into the scenario, create positivity and momentum and build on this to help generate better outcomes for patients that are tailored to their values.

The idea is originally for the MDT approach of Mental Health work but it has been interesting to discuss the approach for General Practice Patients.

You can use these podcasts as part of your CPD - we don’t do certificates but they still count :)

Useful resources:

• Spurrell M, Potts L, Shaw A. Framing Value Based Healthcare in Practice: Introducing the Complex Case and Recovery Management Framework (The CCaRM). Int J Integr Care. 2023 Jan 9;23(1):1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9838237/
• Dr Mark Spurrell Website with resources: www.mark-spurrell.com
• Shared Decision Making Summary guide NHS England and NHS Improvement Feb 2019: https://www.england.nhs.uk/wp-content/uploads/2019/01/shared-decision-making-summary-guide-v1.pdf
• Royal College of GPs 2016: Collaborative Care and Support Planning: Ready to be a reality https://elearning.rcgp.org.uk/pluginfile.php/174399/mod_book/chapter/576/RCGP-CCSP-Ready-to-be-a-Reality.pdf
• The Good Lives Model, a strengths-based approach to offender rehabilitation that can be used in other areas: https://www.goodlivesmodel.com/
• Recovery Star The Outcomes Star for mental health and well-being: https://www.outcomesstar.org.uk/using-the-star/see-the-stars/recovery-star-4/
• NHS Examples of survey tools for use in supported self-management: https://www.england.nhs.uk/personalisedcare/supported-self-management/health-system-support-framework-for-supported-self-management/examples-of-survey-tools-for-use-in-supported-self-management/

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