Holistic Assessments are undertaken to proactively identify the care needs of older people in Southwark and Lambeth. These assessments are done by general practice professionals in a GP surgery or a person’s home.
The Holistic Assessments (HAs) consist of a range of established best practice care pathways for older people, such as: health, social care, mental health, wider social aspects of daily living (e.g. benefits and housing), as well as a focus on self-care and support.
The general practice professionals go through and consider all of these health and wellbeing areas with the person, identifying any areas they feel need proactive action. Before HAs these needs may have been missed by a traditional condition specific GP appointment.
The HAs allow for more time to be spent with the person, to talk through what is important to them, engaging them in their own care and understanding what affects their health and wellbeing.
This results in a proactive care plan, agreed by both the professional and the person, which will be supported and monitored over time.
For more vulnerable people and those who have more complex care requirements the assessment is likely to identify a need for further care co-ordination and support from an integrated care manager and community multi-disciplinary team. This would help resolve any issues and adapt the care plan so it more effectively meets a person’s needs in the community.