Director of Public Health Annual Report 2012 [pdf] - Stoke-on-Trent ...

The importance <strong>of</strong> identifying people with Long-term Conditions
It is important to identify people correctly who have LTCs in order to ensure that they receive
the right care in a timely manner. Receiving the appropriate treatment and management will
slow disease progression and improve health outcomes. Early diagnosis is key to reducing
early deaths from LTCs. There is increasing recognition that painful or disabling illness is a
risk factor for suicide 15 , so attention to the mental health <strong>of</strong> people with LTCs is important.
Why is it so challenging to manage Long-term Conditions
The definition <strong>of</strong> high quality care includes the need for that care to be safe, effective and for
the person receiving it to have a positive experience <strong>of</strong> that care. Maintaining high quality
care for LTCs lies at the core <strong>of</strong> the challenge particularly when many people have more
than one LTC.
Box 3: Challenges to managing Long-term Conditions
• Long-term conditions can be complex and variable
• Evidence based guidance and care pathways focus on single disease, however many
people have multiple LTCs
• Care needs to be co-ordinated across conditions and across services
• Having a LTC can be expensive for the patient, their carer’s and family
• <strong>Health</strong> care resources are not unlimited; 70% <strong>of</strong> all healthcare spending is currently being
spent on LTCs
• The number <strong>of</strong> people with LTCs is increasing
• The link between LTCs and poor mental health can complicate care
• People with LTCs are more likely to have expensive unplanned admissions and planned
care
• Currently the majority <strong>of</strong> expenditure on LTCs is on acute care rather than on prevention
Research and other work undertaken in recent years has broadened our understanding <strong>of</strong>
why the management <strong>of</strong> LTCs can be particularly challenging when individuals have
multimorbidity. The findings from a Scottish Study can be transferred to our local population
to help inform understanding <strong>of</strong> the causes, needs and planning <strong>of</strong> high quality services 24 .
The researchers concluded that “existing approaches need to be complemented by support
for the work <strong>of</strong> generalists, providing continuity, co-ordination, and above all a personal
approach for people with multimorbidity". The Department <strong>of</strong> <strong>Health</strong> and the Kings Fund
have produced a range <strong>of</strong> publications that reflect a growing concern with how to provide the
best care in the face <strong>of</strong> a growing issue <strong>of</strong> such complexity 16,17,18 .
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