Case for change
If we consider people with long-term conditions alone there are 15 million people in England (around 30%) living with long-term conditions (LTCs), and the proportion of people living with multiple LTCs is increasing dramatically, particularly in areas of deprivation.
Most people with LTCs spend just a few hours per year with healthcare professionals and more than 99% of their lives managing their conditions themselves. As such, they need to become experts in their own health and will make all the day-to-day decisions which affect their health. In terms of healthcare this means that the system needs to support individuals to develop the knowledge, skills and confidence to manage their own care.
Traditionally the roles of health services are viewed as cure or care, with the healthcare professionals being the key ‘actor’ in a ‘fix it’ role. LTCs are different - the work of managing a long-term condition happens outwith the relatively short encounters within the healthcare system and so the role of the healthcare professional becomes one of supporting people to understand and manage their conditions independently.
People with LTCs and the organisations that support them such as National Voices, The Kings Fund and Richmond Group make a compelling case for services which are better organised around their needs and, in addition to better prevention and early diagnosis, they ask that clinical care includes:
- Support for self-management
- Greater involvement in decisions about their care (shared decision making)
- Coordination of health and social care
- Emotional, psychological and practical support
The Year of Care approach to personalised care and care and support planning provides a method of supporting all of these activities within a single care pathway and conversation.