SaHF DMBC Volume 1 Edition 1.1.pdf - Shaping a healthier future

Figure 4.3: Spending on long-term conditions across NW London 16
If people with long-term conditions are not cared for well enough in the community, they
create a heavy burden for our hospitals. NW London currently estimates people living with
such conditions account for 67% of all hospital bed days 17 .
Some solutions, such as the Integrated Care Pilot, have been developed within NW London
(further information on the successes of the ICP can be found in Chapter 8.20.4). Elsewhere,
a pilot project in Ipswich has helped 107 patients to better manage their own conditions with
a resulting 75% reduction in GP visits and 75% reduction in bed days in hospital over a sixmonth
period. Staff are being trained to become “health coaches” to their patients.
For older people, receiving co-ordinated and effective support from social care, the NHS and
the local community delivered together enables independent living. When this works well it
can keep people out of hospital and healthier for longer. In hospital older people are often at
risk of developing further conditions that complicate or worsen their health.
Currently, too many older people are admitted to hospital when, with appropriate out of
hospital care, they could be treated in the community and looked after in their own home.
Equally, at the end of people‟s lives, more want to die at home rather than in hospital, and
more needs to be done to enable this. In NW London only 18% of people are dying at home
versus a national average of 23% and in contrast to the wishes of 54% of patients 18 .
4.1.4 Hospitals also need to change to improve the quality of care
While the NHS must focus on keeping people healthy and treating them, where possible, in
the community or their own homes, there will always be the need to treat some patients in
hospitals.
16 Source: Expenditure from 2009-10 programme budget. Number of patients with each LTC - QOF 2009-10
17 Based on Department of Health methodology
18 www.londonhp.nhs.uk/services/end-of-life/case-for-change/
4. The Case for Change 36