To ensure people get the right care and support, the expert panel agreed that a tiered approach could be used in which everyone gets advice for self‑management, with the additional option of supported self‑management if needed. People can then also be offered care from different services to match the level of their needs. The recommendation applies to all age groups and therefore the panel updated the recommendation in November 2021 to allow for discussion with the family or carers of the person if appropriate.
There was not enough evidence to recommend specific criteria for referral and the panel agreed the right level of care would be agreed in shared decision making with the person after their holistic assessment.
The panel updated the recommendation for the November 2021 update to include more information about the decisions that people should be involved in about their care, including whether or not they are referred and when and how support will be provided. The panel agreed that the person should be central in planning their care. This was based on qualitative evidence of patient experience and expert testimony.