Claire Cannings, director of quality and clinical governance at Exemplar Health Care, asks what does ‘holistic’ really mean in nurse-led complex care?
In complex care, supporting someone to live well depends on how effectively different aspects of their care can be brought together.
When care fails to integrate these elements, people are more likely to experience placement breakdowns, prolonged hospital stays, avoidable deterioration, or be supported in settings that cannot fully meet their needs.
Research highlights that this is a growing challenge across the system. For example, the Care Quality Commission’s ‘Monitoring the Mental Health Act 2024/25’ report found that people are waiting too long for care and becoming more unwell while they wait. Meanwhile, Dementia UK’s ‘A Better Death: Fixing Palliative and End of Life Care for Dementia’ report found that people with dementia often don’t receive coordinated end-of-life care, with families left without the support and specialist expertise they need.
Together, these findings point to a wider issue: care too often separates clinical treatment from the broader emotional, social and practical support people need to thrive. Many people come to a company such as Exemplar Health Care at that point, when other services have not been able to bring together the right clinical expertise with support for the whole person.
I believe that in a nurse-led environment, holistic care means fully integrating expert clinical oversight with person-centred support so care is both safe and meaningful.
A holistic approach means supporting the whole person, not simply treating a diagnosis, condition or set of symptoms.
It recognises that physical health, mental wellbeing, emotional resilience, relationships, independence, culture, identity and life goals are all connected. In practice, this means understanding not only what care someone needs, but what matters to them and how they want to live.
In complex care, those wider aspects of life can only be sustained when underpinned by strong clinical expertise. For people living with complex needs, clinical support is often what makes everyday life possible.
Many people are rebuilding their sense of self after a life-changing illness or injury. Others have experienced multiple placements that have not been able to meet the full range of their needs. Some are moving from a home after their needs have progressed beyond what can be safely managed without 24/7 support.
In all these situations, the challenge is not just managing a condition – it is supporting someone to live well, safely and with confidence. That requires a different kind of approach. It means understanding how someone’s health interacts with their routines, mobility, communication, relationships, aspirations and confidence.
It means using clinical expertise to enable independence, not restrict it.
In a nurse-led environment, holistic care is not about providing less clinical care. It is about providing the right clinical care in a way that supports the whole person.
That means:
• 24/7 clinical oversight from skilled nursing teams.
• Proactive management of complex and changing conditions.
• Regular review of symptoms, medicines and treatment effectiveness.
• Support for mental health, confidence and emotional wellbeing.
• Multidisciplinary teams working together around the person.
• Positive risk-taking that helps people do more, not less.
• Care plans shaped by real lives, routines and goals, not just clinical tasks.
• Advocacy, education and support for families and loved ones.
• Helping people build daily living skills, independence and self-management where possible.
It also means taking the time, from the very first conversation, to understand what matters to each person – not just what support they need, but how they want to live. This is not about care plans or pathways. It is about feeling safe, confident and able to live the life they choose.
But there is a wider impact too. Where care brings together the right clinical expertise and a whole-person approach, people are less likely to experience crisis, avoidable hospital admission or readmission, and more likely to achieve lasting stability.
This is where holistic complex care has an important role to play – supporting people in the right place, with the right level of expertise, at the right time.
Holistic care is sometimes used as a broad or vague term. In nurse-led complex care, it should mean something precise. It means combining expert nursing care with support for every aspect of a person’s wellbeing: physical, emotional, psychological, social and practical.
For people with complex needs, that is what makes the difference between simply managing a condition and truly living well, with confidence, dignity and independence. That is what truly holistic, nurse-led care looks like.
Joel moved to Bennett Court in South Elmsall, West Yorkshire, after living in services that could not bring together the clinical support he needed with a structured approach to building independence.
From the outset, a multidisciplinary team worked with Joel to understand what he wanted from life – not just what support he required. With regular physiotherapy and consistent clinical input, he gradually rebuilt his strength and confidence.
He progressed from taking a few steps with a frame to walking to his local shop using a walker.
Alongside this, he developed practical life skills – managing money, planning meals and cooking for himself.
It didn’t happen overnight, but over time these changes meant Joel was able to do more for himself and feel more in control of day-to-day life.
Joel’s story shows how bringing clinical expertise and support for independence together creates the foundation for long-term stability.
When we first met Abi, she had spent a long period in hospital and rehabilitation following a spinal injury. Her previous placement had not been able to bring together the level of clinical support she needed with her day-to-day independence, which affected her confidence and mobility.
Our nursing team reviewed how her symptoms were being managed and worked with her to find a more effective clinical approach.
With the right support in place, alongside physiotherapy and adaptive equipment, Abi began to feel safer and more in control.
That clinical stability made a difference. She started going out again – seeing friends, going to gigs, and reengaging with the things she enjoys. Over time, her health improved, her confidence grew, and she was able to take back more control of her daily life.