Chronic disease – more than medicine
A signal of the success in tackling the health problems of the 21st century is the emergence of Long Term Conditions as the dominant problem for health and care systems worldwide.
Addressing the wider determinants of health along with prevention against infectious diseases, complemented by advances in treatments and technologies means people are living longer and people who once would have died in infancy or youth are living into adulthood.
The changes in life expectancy and advances in treatments and technology however, mean that people are living with conditions that cannot be cured but need to be managed to minimise the impact on their lives and maintain their quality of life. The recent past has also seen this issue become more complex with the emergence and growth of multi-morbidity. More and more people are living with two or more conditions.
The dominance of LTCs and specifically multi-morbidity requires policy and practice to change to meet the needs of the future rather than those of the past. People need to be supported to manage their health, to have more knowledge, skills and confidence to do so and to take more control of their health and lives. People need more than medicine, person-centred care sits at the heart of this change.
The National Health Service in England has a vision that supports people to gain far greater control of their own care and for the development of new models of care that will ultimately contribute to preventing some LTCs, and improve the quality of life for people who acquire or develop them. For the vision to become a reality, the functions that models of care are required to deliver need to be clear. In addition, the drivers and enablers to support the functions need to be in place and inhibitors removed. Some of these are technocratic but some are about human behaviour: attitudes, mind-sets, values and needs, in both professionals and people with LTCs.
Progress is being made, however, much is still needed. I’m very much looking forward to sharing our experiences so far and learning how colleagues in Canada are tackling these same challenges.
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