Fragmentary and Divided Services? Summary of countrywide supervision of municipal health and social services for adults over 18 years of age with complex and long-term needs for services.

In 2005 the Norwegian Board of Health in the Counties carried out country-wide supervision in 60 Norwegian municipalities. The aim of supervision was to examine how municipalities, through systematic management, ensure that people with complex and long-term needs for health and social services receive comprehensive and coordinated care during all stages of their treatment and care, and thus ensure that clients receive adequate services that are in line with statutory requirements.

The results of supervision show that the municipalities have not established management structures that are robust enough to ensure that service sectors, together and in cooperation with clients, carry out an adequate investigation of clients’ needs. Such an investigation is necessary in order to plan service provision that fulfils the requirements laid down in the legislation. 

In the opinion of the Norwegian Board of Health, it is a serious situation that municipalities do not ensure that a multidisciplinary assessment and investigation is carried out for clients who have complex health care and social needs. Deficiencies in one or several service sectors influence the comprehensiveness of the services that are offered and whether the services are in line with statutory requirements. When assessment of service needs is inadequate, and when planning of service provision is fragmentary and in some cases inadequate, then the services offered may not be adequately organized and adapted to meet the needs of individual clients. The results of supervision give reason to believe that follow-up and evaluation of service needs and service supply may not be not systematic.