Local Government Association

This report explores the role of sport, arts and culture in supporting community cohesion.

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Feedback: 23 October 2025

The HICM is designed to support system partners to self-assess how local care and health systems are working now, and to reflect on, and plan for, action they can take to deliver improvements in care and achieve efficiencies and savings throughout the year.

The High Impact Change Model: Optimal Handed Care is intended for use by ‘Health and Care Systems’, a collective term used to describe local partners inclusive of NHS bodies.

The health and care landscape in England is under unprecedented strain. Rising demand, increasing health and care complexity, workforce pressures, and relentless financial constraints demand a paradigm shift. Optimal Handed Care (OHC), focused on maximising individual independence and delivered by the right professional at the right time, is critical in supporting a sustainable and high-quality system.

Alongside the national available guidance for carers’ support and investment, health and care systems should consider the following actions for embedding optimal handed care support and training across different pathways.

Seamless transfer of care from hospital into the community requires consistent application of optimal handed care principles across the system. Consistency across assessment, equipment provision, workforce competence, and governance ensures that patient safety, independence, and system efficiency are sustained beyond the boundaries of one care setting.