Introduction to long term conditions Flashcards
what is a long term condition?
- health problem that requires ongoing management over a period of years or decades
how are long term conditions managed?
- cannot, at present, be cured but is controlled by medication and/ or other treatment or therapy
what percentage of the UK population have one long term condition?
- 40%
> year
what is the people with multiple long term conditions increasing with? - 2008 stats compared to 2018
- increasing with ageing population
- 2.9 million in 2018 from 1.9 million in 2008
what percentage of people in the UK have multimorbidity? (different age groups stats)
- 65% of people aged 65-84 in the UK have two or more conditions
- rising to 82% of those > 85
how much does long term conditions account for inpatient bed days, GP appointments and health and social care spending?
- 70% of inpatient bed days
- 78% of GP appointments
- 70% of health & social care spending (most intensive users of expensive services)
how does socioeconomic status impact multimorbidity?
- socioeconomically deprived people develop multiple conditions 10-15 years younger than their affluent peers
how does social class contribute to prevelance and severity of conditions?
- compared to social class I, people in social class V have 60% higher prevalence of long- term conditions and 30% higher severity of conditions
what is the prevalence of long term conditions in England?
- over 18 million in England
what are the most prevalent long term conditions ? (6)
- cardio-vascular disease
- musculoskeletal disorders
- cancer
- mental ill health
- dementia
- chronic respiratory disease
why are depression, mental illnesses and learning difficulties higher in 20-40 year olds compared to over 60s?
- due to increased awareness of conditions e.g., help offered for mental illness
why are sensory, CVDs, diabetes and progressive illnesses more prevalent in people over 60 years old?
- due to body misuse e.g., more inactivity as well as general cognitive decline
what two factors are people with multimorbidity likely to have?
- more likely to have risky health behaviours e.g., drugs, alcohol
- 3-7 times more likely to have a mental health disorder
what does multimorbidity reduce and why?
- reduces people’s quality of life
- particularly through having chronic pain
what likelihood increases in people with multimorbidity?
- increased likelihood of not working
- half as likely
what are the 5 steps of the current model of care?
- patient presents to GP
- GP suggests diagnostic tests
- GP diagnoses and manages LTC
- If LTC becomes unmanageable, pt is referred to specialist
- Specialists manage LTC for 2 years and when stable send pt to GP
what did the Health and Social Care Act of 2012 identify?
- identified that care should be integrated around the needs of the individual, and that people should be able to make decisions about their own care
what do healthcare landscapes work on?
- work together to improve quality, efficiency and outcomes
what did the Health Care Act of 2022 give legal power to?
- legal power given to integrated care systems
what did the Health Care Act of 2022 create?
- integrated care boards (ICBs)
what is the delivery like in the Health Care Act of 2022?
- Collaborative delivery
what are integrated care systems?
- local partnerships that brings health and care organisations together
what do integrated care systems develop?
- develop shared plans to join up health and care services to improve lives
what are integrated care partnerships?
- broad alliance of partners who have a role in improving local health, care and wellbeing
what are the examples of what the integrated care partnership improve?
- NHS
- local councils
- social care providers
- voluntary
- community
- social enterprise
- VSCE sector
what does each ICP develop? what happens to this?
- each ICP develops comprehesive long- term strategy to improve health and wellbeing then its jointly run by the NHS ICB and upper tier local authorities
what is an integrated care board?
- legal NHS organisation which plans how to meet the health needs of their local population based on the integrated care strategy
what do the integrated care board manage and arrange?
- manage the NHS budget
- arrange for local health services to be provided
what do place- based partnerships do ?
- they design and deliver integrated service for areas within the ICS
what are the examples of the place based partnerships?
- town
- borough
- neighbourhodo
what does place- based partnership involve? what are some examples?
- involves a range of people interested in improving health and care
e.g., NHS, local councils, VSCE, local people
what do provider collaboratives bring together?
- bring together providers of local health and care services across several places, and sometimes different ICSs
who do provider collaborative groups involve?
- acute, community and mental health hospitals
- primary care
- social care
what is a collaborative problem?
- both patients and providers contribute their perspectives and priorities to defining the issues addressed by clinical and educational interventions
what is targeted in treatment?
- approach the target that issues of greatest importance to both the patient and provider
what goals and plan should be put in place for treatment?
- realistic goals set
- personalised improvement plan developed
what two patient factors determine the likelihood of following the treatment plan?
- self- efficacy
- patient’s readiness to change
what are the 4 self management training and support services offered?
- instruction in disease management
- behaviour change support programs e.g., smoking or dietary intervention
- exercise options
- interventions to deal with the emotional demands of chronic disease
how are follow ups implemented? are they important?
- follows up should be reliable, performed at regular intervals and initiated by the provider
- important as they lead to better outcomes
how would you describe long term condition services?
- person- centred
- co- ordinated
what does the LTC service design support?
- supports self- management
- tailored information, education and training, technologies and peer & community support
how does the LTC service design engage patients?
- engage people in decisions
what does the LTC service design provide? (3)
- provide prevention, early diagnosis and intervention
what three types of support does the LTC service design offer?
- emotional
- psychological
- practical support
what are the 5 challenges of the LTC service design?
- organisation of care
- inadequate training
- attitudes of practitioners
- lack of incentives
- service users factors
how does organisation of care act as a challenge?
- top down
- medicalised primary care
- workload
- time
how does the attitude of practitioner act as a challenge?
- patient centred
- power dynamics
how does service user factors act as a challenge?
- knowledge
- attitude
- confidence
