Extending the care and support planning approach to multiple long-term conditions
Delivering a care and support planning approach for people with multiple long-term conditions can improve their experience of care and could reduce GP practice costs.
Moving from using care and support planning for people with a single condition (such as diabetes) to those with multiple conditions improved the experience of patients in the programme. They appreciated having a single consultation that covered all their health concerns.1
The House of Care programme introduced the care and support planning approach for cardiovascular disease, which includes LTCs such as coronary heart disease, stroke, hypertension, hypercholesterolaemia, chronic kidney disease, peripheral arterial disease and vascular dementia. Some practices also adopted a care and support planning approach for supporting people with chronic pulmonary obstructive disease and heart failure.
In addition, although the programme set out to demonstrate improved quality of care rather than reduced costs, a consistent finding across all sites was that using care and support planning to help people self-manage more than one LTC is where the greatest resource savings look likely.2
This is not the magic wand that will make people better, but it has put cardiovascular disease on the map. It’s focused primary care to relook at how they manage their LTCs more generally; it will be a stepping stone to managing other LTCs in a similar way in the long term.
An illustrative analysis by NHS Tayside suggests that a care and support planning approach covering two LTCs in a single consultation could reduce costs by 25% (£2.99).2 If five LTCs could be covered in a single consultation, this would reduce costs even further – by up to 70% (£21.10).3
Sites said the House of Care framework was particularly valuable in helping them to adopt a care and support planning approach for multiple LTCs by giving practices a structure to extend these changes.1 All sites are now using the House of Care framework for at least one LTC and are planning to include more in the near future.
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1 ICF Consulting Ltd, 2018. House of Care Evaluation: Final Report, page 82
2 ICF Consulting Ltd, 2018. House of Care Evaluation: Final Report, page 74
3 ICF Consulting Ltd, 2018. House of Care Evaluation: Final Report, page 73