Michael Wright, Programme Director, Guy's and St Thomas' Charity
Apr 20, 2017
“I wait weeks to get a double appointment. I write down all the things I need to say but I don’t get time. I am told I am only allowed to mention two symptoms.”
Tina is in her late 50s. She is a former army nurse and lives on her own in Southwark. And she has multiple long-term conditions (LTCs) including Lupus, which is very complex and affects many parts of the body.
In Lambeth and Southwark, over 11,200 local people live with three or more long-term conditions. They are part of the 15 million in the UK living with a LTC, a number that is growing. People with long-term conditions often experience disjointed care and have poor quality of life. Tina’s story of healthcare is not uncommon and we think this needs to change.
As a foundation interested in the major health issues facing our local communities, we’re taking a new approach. We’re building highly focused programmes of work, and one of them is setting out to improve the health and care of people in our communities living with several physical or mental long-term conditions.
Living with one or several LTCs can often be life-altering for the person and those supporting them. Repeated clinical appointments and multiple medications are the norm, and almost one in three also experience poor mental health.
Living with multiple long-term conditions also impacts on family relationships as family members may take on caring responsibilities which increase as the underlying burden of disease grows. Work often becomes difficult, needing to take time off for medical appointments, sickness absence, reduced mobility and ill mental health. Patients may need to adapt their home or move to remain independent. It can also often have an impact on income – reduced working or increasing reliance on benefits may make it difficult to secure or retain good quality accommodation, or even to eat well.
Alongside that, diagnosing and managing LTCs also comes at a big financial cost. 70% of the national NHS budget is spent on the 30% people with one or more long-term condition and over half of all GP appointments relate to long-term conditions.
Better integration between health and social care is also high on the national health agenda. Our local authorities and NHS colleagues have made important progress in this area too, including ambitious initiatives like Southwark and Lambeth Integrated Care (SLIC), which we supported. We’ve also backed projects to transform care for local people with heart failure, who often live with other chronic conditions, and to identify and treat mental health issues in people with an LTC.
Today, we want to focus on local people with LTCs facing a particularly tough battle – those with several life-altering long-term conditions. Our hope is that what we learn here informs approaches elsewhere.
Our work has only just begun. To start with, we want to find out from them what really matters, in their lives and health. We want to help empower them to self-manage better, and to support the health and care systems to work more efficiently for them and their carers.
In understanding potential solutions, we’re looking around us and finding out more about where and how our local people live. We have a specific combination of characteristics in our boroughs – a densely-populated environment, high diversity among our communities and strongholds of deprivation – which we believe impacts on the health of people with multiple long-term conditions. We are setting out to find out more and our programme decisions will be based on what we learn.
Top of the list for this initial phase of our work is learning from what others are doing, exploring new approaches and connecting with people who can help drive change. We will be strongly led by evidence and, in turn, we hope to generate fresh new insights of use to others facing similar challenges elsewhere. If you think you can contribute to the quest, find out more about our programme and to get in touch.
Programme lead: Dr Mike Wright
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