Quality statement 9: Collaborative care

Quality statement

People with moderate to severe depression and a chronic physical health problem with associated functional impairment, whose symptoms are not responding to initial interventions, receive collaborative care.

Quality measure

Structure: Evidence of local arrangements to provide collaborative care to people with moderate to severe depression and a chronic physical health problem with associated functional impairment, whose symptoms are not responding to initial interventions.

Process: Proportion of people with moderate to severe depression and a chronic physical health problem with associated functional impairment, whose symptoms are not responding to initial interventions, who receive collaborative care.

Numerator – the number of people in the denominator receiving collaborative care.

Denominator – the number of people with a chronic physical health problem and moderate to severe depression with associated functional impairment whose symptoms are not responding to initial interventions.

What the quality statement means for each audience

Service providers ensure systems are in place for providing collaborative care to people with moderate to severe depression and a chronic physical health problem with associated functional impairment, whose symptoms are not responding to initial interventions.

Healthcare professionals ensure collaborative care is provided to all people with moderate to severe depression and a chronic physical health problem with associated functional impairment, whose symptoms are not responding to initial interventions.

Commissioners ensure they commission services that provide collaborative care for people with moderate to severe depression and a chronic physical health problem with associated functional impairment, whose symptoms are not responding to initial interventions.

People with moderate to severe depression and a long-term physical health problem affecting their everyday life, whose symptoms have not improved after early treatments, receive 'collaborative care', which means that a dedicated team of healthcare professionals work together to treat the depression and the physical health problem.

Definitions

NICE clinical guideline 91 states that collaborative care should form part of a well-developed stepped-care programme. In stepped care the least intrusive, most effective intervention is provided first; if a patient does not benefit from the intervention initially offered, or declines an intervention, they should be offered an appropriate intervention from the next step.

Collaborative care requires that the patient and healthcare professional jointly identify problems and agree goals for interventions, and normally comprises:

  • case management which is supervised and supported by a senior mental health professional

  • close collaboration between primary and secondary physical health services and specialist mental health services in the delivery of services

  • the provision of a range of evidence-based interventions

  • the long term coordination of care and follow-up.

Source guidance

NICE clinical guideline 91 recommendation 1.5.4.1 and 1.5.4.2.

Data source

Structure: Local data collection.

Process: Local data collection.