Approximately 15 million people in England are living with Long Term Conditions (LTCs). The NHS and NHSE report that LTCs now account for about 50% of all GP appointments, 64% of all outpatient appointments and over 70% of inpatient bed days..
Understanding their condition is the first step for LTC patients in coming to terms with their diagnosis and this can be frightening. Information and support for both physical and mental well-being is very important. In NHSE surveys, patients with LTCs say that they want to be supported to engage in their care and contribute to decisions about it.
Advice & Guidance (A&G) has a significant part to play in integrating physical and mental health care and keeping patients involved in their own care, especially when rapid and timely advice is needed for complex cases.
Ways A&G can help
- We know that GPs, Nurses and Psychiatrists are increasingly using rapid Telephone A&G to discuss a patient’s care with a Secondary Care specialist Watch this short video.
- Mental health trusts use A&G to manage Mental Health inpatient wards. Communicating with Secondary care colleagues this way often removes the need for LTC patients to endure a visit to another hospital and can aid appropriate discharging.
- Photo A&G enables GPs and Nurses to record detailed and accurate images to assist specialist clinicians in the diagnosis and monitoring of patient conditions, disease and progress. This in turn can have positive impact on patient mental health. Read this case study.
- Where local LTC specialists struggle with lack of capacity, out-of-area LTC NHS specialists can provide a ‘central’ resource (National Consultant Network). This breaks down ‘post-code lottery’ barriers, improves patient care, and enables local consultants to see the LTC patients they really need to see.
In practice – case studies
Elderly patient with heart condition
“I was able to avoid admitting the patient and she remained in her own home whilst I adjusted her medication, which is what she wanted. Having a clear plan gave her reassurance and me confidence to manage her when she was more unwell.” Read Dr Lorna Burn’s case study here.
Pregnant Patient with Hypothyroidism
“Being able to speak to the consultant directly and during my consultation with the patient meant that I could reassure the patient there and then. “ Read Dr Robert Weaver’s case study here.
Elderly man with Arthritis
“Speaking to the consultant made me feel confident to continue to support the patient and his wife, and meant they knew what was likely to happen. They had a chance to read preparatory patient information so could make an informed decision regarding starting a DMARD in that first outpatient appointment.” Read Dr Emma Rowley-Conwy’s case study here
Patient Initiated Follow Up Service (PIFU)
In parallel to the existence of an effective A&G service more and more areas are offering LTC patients access to a Patient Initiated Follow Up Service (PIFU). This service is specifically designed to allow patients access to clinical teams as and when they have a flare up of their condition. To find out more about Consultant Connect PIFU solution, click here.
Other useful links
- Kings Fund – Time to think differently – LTCs
- Nuffield Trust – Commissioning high-quality care for people with long-term conditions