Transcript David Colin-Thomé • National Clinical Director for Primary Care • GP, Castlefields, Runcorn • Honorary Visiting Professor, Centre for Public Policy and Management, Manchester University •

David Colin-Thomé
• National Clinical Director for Primary Care
• GP, Castlefields, Runcorn
• Honorary Visiting Professor,
Centre for Public Policy and Management,
Manchester University
• Honorary Visiting Professor, School of Health,
University of Durham
• Adviser to Central Manchester University
Hospital
Our health, our care ,our say –a new
direction for community services
(www.tso.co.uk/bookshop)
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Ambition
Enabling health, independence and well being
Better access to GP
Better access to community services
Support for people with longer term needs
Care close to home
Ensuring reforms put people in control
Making sure change happens
THE NHS, IN COMMON WITH HEALTHCARE SYSTEMS WORLDWIDE, FACES AN
INCREASING CHALLENGE IN TREATING THOSE WITH LONG TERM CONDITIONS
INCIDENCE OF LONG TERM CONDITIONS
• There are over 15 million people in
England with longer term health
needs
• The proportion of over 65s living with
a chronic condition has risen from
48% in 1972, to 62% in 2002
• Half of all very high intensity users are
aged 75 or over, compared to just over a
quarter of all hospital inpatients
Source: DH publication ‘Chronic Care Compendium’; DH website
IMPACT ON NHS RESOURCES
• Around 80% of GP consultations
relate to long-term conditions
• Care of long-term conditions
accounts for 60% of bed days in
hospitals
• Two thirds of patients admitted as
medical emergencies have an
exacerbation of a long term condition
The NHS and Social Care
Long Term Conditions Model
Delivery System
Infrastructure
Community
Resources
Better outcomes
Case Management
Health and social
system environment
Disease
Management
Supported
Self care
Promoting Better
Health
Creating
Decision support
tools and clinical
information system
(NPfIT)
Supporting
Empowered and
informed patients
Prepared and
proactive health and
social care teams
Public Service Agreement
To improve health outcomes
for people with long term
conditions by offering a
personalised care plan for
vulnerable people most at risk;
and to reduce emergency bed
days by 5% by 2008, through
improved care in primary care
and community settings for
people with long term
conditions.
Already seeing results
Bed days, admissions and average length of stay (2003-04 = 100)
Recent trends in emergency bed days, admissions and
length of stay
admissions
110
105
EBDs
100
95
90
Bed days
85
Admissions
LOS
Average length of stay
80
Mar- Apr-04 May- Jun-04 Jul-04 Aug04
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Source: Hospital Episode Statistics
Sep- Oct-04 Nov04
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Dec- Jan-05 Feb04
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Mar- Apr-05 May- Jun-05 Jul-05 Aug05
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Sep05
LTC
• 50% of people with LTCs have not been
told about treatment options
• 25% do not have care plan
• 50% do not have a self care plan
• 50% medicines are not taken as intended.
Range of White Paper LTC
commitments
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Bigger emphasis on self care and integration
Requirement for multidisciplinary
teams/networks
Universal case management for VHIUs
Personal Health and Care Plans
Assistive Technology
24/7 single point of contact for people with
complex needs