Michael Parsons, Portfolio Manager, Guy's and St Thomas' Charity
Sep 26, 2019
At the Charity, we have a long history of working with the healthcare system. Our vision for what health care is – place-based, insight-led, rooted in the lived experiences of people, more than just disease – is shared by many partners in the local healthcare system.
Along with our work looking at social risk factors, our healthcare strand is part of how we intend to slow down progression to multiple long-term conditions through our ten-year programme. In this strand, we are looking to improve the early detection and management of common physical and mental health conditions that research suggests lead to more long-term conditions.
Our work is also looking at supporting healthy behaviours – including through addressing the environments which promote unhealthy habits – to prevent onset of multiple long-term conditions. We're paying close attention to clinical risk factors such as poor mental health, high blood pressure, obesity, smoking and alcohol consumption.
Our multiple long-term conditions programme is exploratory – in that we’re still learning about who is most affected and what interventions work. Initial evidence – including our own research – shows that people living in low-income areas tend to develop long-term conditions earlier than those living in more affluent areas. That's why we're trialling projects that tackle inequality and deliver in areas with the highest levels of deprivation in Lambeth and Southwark.
We also believe that weighting our work towards people’s experience of diabetes and chronic pain is a good place to start. For example, our work with the Lambeth GP Federation’s Clinical Effectiveness Group seeks to improve people’s experience of care for type 2 diabetes and reduce inequalities in care outcomes. This contributes to our ambition to reduce the number of people with diabetes who develop another long-term condition. The insights from this project should help us learn more about progression from one to multiple long-term conditions, plus this learning-by-doing approach will improve clinical skills and patient outcomes.
Our work on healthcare in the community is developing in different ways. For example, we're supporting Partnership Southwark’s bold vision of making the borough ‘an amazing place to live a full healthy life’, by trying out new, cross-sector ways of working in neighbourhoods across Southwark. In Lambeth, we’re supporting the Grantham Practice in Stockwell and the Lambeth Portuguese Wellbeing Partnership to work together to develop preventative approaches that support good health. They’ve created a multi-disciplinary team, drawing on professionals and volunteers from healthcare and local voluntary sector organisations, to work with families as a whole – considering the overlapping and interrelated problems facing households.
These approaches teach us that it’s unreasonable to expect single organisations to have all the expertise to tackle complex urban health issues. For example, today it's some stretch to expect GPs to have a full overview of social risks in their communities, or outreach workers to know about the inter-relationship between long-term conditions. To deal with that, we’re doing two things. First, we're encouraging organisations from across healthcare, employers, housing and the voluntary sector to work together as they develop projects with us. Second, we offer a rounded package of support, including expertise around multiple long-term conditions, funding, evaluation and project management.
We want to work with others to test new ideas to see what works to slow down progression. We’re looking to partner with individuals and organisations who are working on projects – or have ideas for how – to slow down progression to multiple long-term conditions. We need support to explore questions like:
Portfolio Manager: Michael Parsons
23 April, 2020
As a funder, our priority is to support our partners and the communities most affected by COVID-19. Our Portfolio Director, Louise Mousseau, sets out the actions we've taken to date and how we're adapting our work in response to a changing environment.
25 February, 2020
Our Programme Director for multiple long-term conditions, Barbara Reichwein, reflects on persisting health inequalities ten years on from the Marmot Review.