Delivering person centred care in long term conditions
BMJ 2015; 350 doi: https://doi.org/10.1136/bmj.h181 (Published 10 February 2015) Cite this as: BMJ 2015;350:h181
- Simon Eaton, clinical lead1,
- Sue Roberts, chair1,
- Bridget Turner, director of policy and care improvement2
- 1Year of Care Partnerships, Northumbria Healthcare NHS Foundation Trust, North Shields NE29 8NH, UK
- 2Diabetes UK, London NW1 7AA, UK
- Correspondence to: S Eaton simon.eaton{at}northumbria-healthcare.nhs.uk
Long term conditions are a major challenge to the sustainability of health services globally.1 Their increasing prevalence is associated with growing rates of preventable complications and premature mortality, resulting in soaring costs (box 1).2 3 4 5 These factors, coupled with higher expectations among patients and the public,6 create an urgent need to redesign health services, which are still largely geared to providing episodic acute care.7 8
Box 1: Impact of long term conditions
Around half of the population in the US2 and 40% in the UK3 have a long term condition
Multimorbidity is increasing—65% of people aged 65-84 in the UK have two or more conditions, rising to 82% of those ≥85. However most people with multimorbidity are younger than 653
People with multimorbidity are 3-7 times more likely to have a mental health disorder3
Socioeconomically deprived people develop multiple conditions 10-15 years younger than their more affluent peers3
Long term conditions in the UK account for 70% of inpatient bed days,4 78% of GP appointments,[5 ]and around 70% of health and social care spending4
Definitions of long term conditions as “health problems that require ongoing management over a period of years or decades”9 fail to reflect the personal, social, and economic burden on the individual, their families, and wider community. Nor do they acknowledge that people with long term conditions spend just a few hours a year interacting with clinicians and healthcare services and more than 99% of …