Community care homes: from psychologists to community nurses, here’s who residents will find there

It is not just doctors and nurses. In community care homes, healthcare, social care and administrative professionals will need to work together, with the team expanding according to the individual’s needs. This is one of the most concrete aspects of the guidelines issued by Agenas, the Agency for Regional Health Services, on multi-professional and multidisciplinary teams, which were finalised on 8 September following a public consultation. Compared with the first draft of April 2026, the overall framework remains unchanged, but the professionals involved, their responsibilities and the way in which they are to collaborate have been clarified. A total of 764 individuals and organisations took part in the consultation, submitting 5,060 comments; 509 contributions were assessed. The amendments primarily strengthen team composition, mental health, prevention and links with the local community. For members of the public, the first thing to bear in mind is that not all ‘Case’ centres will necessarily have all the required professionals present at the same time and in the same building. The model is one of ‘variable geometry’: a stable core, to which the necessary expertise is added depending on the patient’s needs and the population served.

The core of the team continues to consist of the doctor in the single primary care role – the general practitioner – or the paediatrician of the patient’s choice, the nurse, the social worker and administrative support staff. Many submissions proposed expanding this core, but Agenas has chosen to keep it streamlined and flexible. The primary care doctor is the patient’s clinical point of contact. This is an important clarification in the final text: working as a team does not mean blurring responsibilities. Other professionals may be called upon to support the doctor when the patient’s care pathway requires it. Among the most recognisable roles will be that of the family or community nurse, recognised as a key local point of contact. They will be required to contribute to the continuity of care and liaise between the various team members, playing a particularly important role for older people, vulnerable individuals and those with chronic conditions, who need long-term support rather than just a one-off service. The social worker forms part of the core team because many health needs also have a social dimension. Loneliness, family difficulties or financial hardship can affect a person’s ability to seek treatment. The Centre must therefore liaise with social services and local resources, whilst administrative support must facilitate citizens’ access to and guidance through the care pathway.

The most noticeable change is the expanded team. The final text contains more explicit references to psychology, mental health, rehabilitation, prevention, healthcare assistants, occupational therapists, professional educators and National Health Service pharmacists. This does not mean that every care home must have all these professionals on a permanent basis, but that they must be genuinely available when needed. The psychologist takes on a more cross-cutting role, and reference is also made to the primary care psychologist. For patients, this means being able to address, as part of an integrated care pathway, any psychological issues that may accompany a chronic illness or a condition of frailty, with closer links to mental health services. The NHS pharmacist is more clearly linked to treatment adherence and appropriateness – an important issue for those taking multiple medicines or undergoing complex treatments. Rehabilitation professionals, such as occupational therapists and vocational trainers, may be involved in the care pathway when the need relates to functional recovery, independence or educational support; prevention specialists and healthcare assistants may also contribute to community-based interventions.

Another clarification concerns the case manager. This will not necessarily be a new professional role, nor will it always be the same person. Case management is, in fact, defined as an organisational model: the role may be carried out, on a case-by-case basis, by the professional best suited to the client’s prevailing needs. The local community also plays a more prominent role in the final version. Community centres will need to understand their target population, identify the most vulnerable individuals and areas, and liaise with social services, the third sector, associations, pharmacies and local networks. The aim is not simply to wait for citizens to come to the help desk, but to anticipate their needs in advance, particularly those of the most vulnerable or hard-to-reach people. For the patient, therefore, a multi-professional approach does not simply mean finding many professionals under one roof. It means that doctors, nurses, social workers, psychologists, pharmacists and other necessary practitioners share the care pathway and work as a team.

+So far, the debate has focused mainly on how many facilities have been built or declared operational. The AGENAS Guidelines shift the focus to what the public should find once they enter: approachable professionals, clear roles, coordinated care pathways and a continuity of care that does not force them to start from scratch every time. The final text maintains a focus on outcomes, but not solely on the number of services provided: what matters is continuity of care, adherence to treatment, avoidable hospital admissions and A&E visits, quality of life and the experience of those receiving care. The real test will be ensuring that the required professional expertise is actually made available. The ‘variable geometry’ approach may allow for responses better suited to different needs, but it only works if the members of the extended team can genuinely be called upon when the patient needs them. The success of the Community Centres will therefore be measured less by the number of centres in operation and more by their ability to bring together different professionals into a recognisable, accessible and useful team for the public.