Authors' objectives: Self-neglect can have serious consequences for individuals’ self-care, health and well-being, and requires collaboration between many practitioners, from adult social care, health, fire and rescue, environmental protection and other organisations. Yet practice reviews highlight repeated failings in working together. This National Institute for Health and Care Research-funded study aimed to identify what problems arise in interagency and interprofessional practice with self-neglect within relevant contexts, and develop realist theory describing how they might be addressed.

Authors' results and conclusions: Professional curiosity in safeguarding must be complemented by greater ‘interprofessional curiosity’, supported structurally, procedurally and managerially, if interagency working is to fulfil its potential contribution to improving the lives of people experiencing self-neglect.

Authors' methods: A realist review of 41 international research publications, 273 Safeguarding Adults Reviews (local statutory reviews of interagency safeguarding practice cases where it is felt there are ‘lessons to be learnt’) from England, and 85 Safeguarding Adults Board policies and procedures was undertaken to map evidence on collaborative working with self-neglect. Interviews were undertaken with 69 practitioners and managers from relevant agencies, 16 people with lived experience of self-neglect and 2 family carers about their experiences of collaborative working. A selection of 100 Safeguarding Adults Reviews featuring self-neglect was analysed as a set of case studies to estimate the use of services, and costs to agencies of support. Three focus groups were held with seven practitioners to coproduce research translation for use by services from the findings. Four workshops took place to pilot this research translation with practitioners; 73 participants responded to a post-workshop survey. Follow-up interviews with nine practitioners took place to further validate the study’s conclusions.

Project Status: Completed

URL for project: https://www.journalslibrary.nihr.ac.uk/programmes/hsdr/NIHR136252

Year Published: 2026

URL for published report: https://www.journalslibrary.nihr.ac.uk/hsdr/GJDO0815

URL for additional information: English

English language abstract: An English language summary is available

Publication Type: Full HTA

Country: England, United Kingdom

DOI: 10.3310/GJDO0815

Organisation Name: NIHR Health Services and Delivery Research programme

Contact Address: NIHR Journals Library, National Institute for Health and Care Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK

Contact Name: journals.library@nihr.ac.uk

Contact Email: journals.library@nihr.ac.uk