Penny Sargent1, Ruth Boaden, Martin Roland. 1. Manchester Business School, National Primary Care Research and Development Centre, University of Manchester, Manchester, UK.
Abstract
AIM: To describe actual patient caseload sizes among case managers for long term conditions and explore issues of caseload manageability. BACKGROUND: Department of Health guidance advises that community matron case managers for long term conditions should manage caseloads of 50-80 patients. However, there is currently no evidence to justify these caseload targets. METHOD: In-depth interviews were conducted with 46 case managers for long term conditions, five clinical leads and six programme leads across six Primary Care Trusts. FINDINGS: Case managers had caseloads of 10-55 patients each, although numbers fluctuated from week to week. The current caseload target was regarded as difficult to manage. Heavy caseloads were perceived to result in a shift from proactive care towards reactive care, decreased quality of care and increased hospital admissions. CONCLUSION: Case managers for long term conditions are struggling to achieve and maintain caseload targets. Further research is necessary to identify the most appropriate caseload size and provide an evidence base for policy. IMPLICATIONS FOR NURSING MANAGEMENT: Programme leads and managers need to carefully assess the local situation, the characteristics of the target population and the practicalities of delivering the model of care before identifying appropriate caseload targets.
AIM: To describe actual patient caseload sizes among case managers for long term conditions and explore issues of caseload manageability. BACKGROUND: Department of Health guidance advises that community matron case managers for long term conditions should manage caseloads of 50-80 patients. However, there is currently no evidence to justify these caseload targets. METHOD: In-depth interviews were conducted with 46 case managers for long term conditions, five clinical leads and six programme leads across six Primary Care Trusts. FINDINGS: Case managers had caseloads of 10-55 patients each, although numbers fluctuated from week to week. The current caseload target was regarded as difficult to manage. Heavy caseloads were perceived to result in a shift from proactive care towards reactive care, decreased quality of care and increased hospital admissions. CONCLUSION: Case managers for long term conditions are struggling to achieve and maintain caseload targets. Further research is necessary to identify the most appropriate caseload size and provide an evidence base for policy. IMPLICATIONS FOR NURSING MANAGEMENT: Programme leads and managers need to carefully assess the local situation, the characteristics of the target population and the practicalities of delivering the model of care before identifying appropriate caseload targets.
Authors: Steve Iliffe; Shelley Peacock; Anganie Seecharan; Ajit Shah; Prakash Chatlani; M C Patel; Karen Phekoo; Ricky Banarsee Journal: London J Prim Care (Abingdon) Date: 2011-07
Authors: Geraint Lewis; Martin Bardsley; Rhema Vaithianathan; Adam Steventon; Theo Georghiou; John Billings; Jennifer Dixon Journal: Int J Integr Care Date: 2011-06-30 Impact factor: 5.120