Like some of the social services authorities round St Christopher’s, Devon County Council is separating its service-fixing function from its community care assessment. This looks efficient, because from the Council’s point of view, they can deal with the easy cases by bureaucracy. However, from the service user’s point of view it means that once an assessment is made, they lose continuity of service from a care manager. And from an end-of-life care service point of view, there’s no care manager with a continuous knowledge of what’s happened to a patient. So further along the line, the service user does not get the benefits that come from continuous service. And it goes against the research, which says that the ‘travel agent’ model of care management, where the care manager just fixes the services, does not work as well as the ‘travel companion’ model, where they stay with the service user throughout the process (Rapp, C. A. and Roscha, R. J. (2004) The principles of effective case management of mental health services. Psychiatric Rehabilitation Journal 27(4): 319-33). Never mind the research, this is common sense: it just doesn’t feel caring if you get a succession of people dealing with you instead of a continuous involvement.

Pics of memorials in St Nick’s curchyard, Sutton