15 million people in England (around 30%) live with long term conditions (LTCs), and the proportion with multiple LTCs is increasing dramatically.

LTCs are the most common cause of death and disability. People with LTCs account for:

  • 70% of the money spent on health and social care
  • 55% of GP appointments
  • 68% of hospital outpatients
  • 77% of inpatient episodes
  • Over half of the overall cost of looking after older people in residential homes

Traditionally the roles of health services are viewed as cure or care, with the healthcare professionals being the key ‘actor’ in a ‘fix it’ role. LTCs are different - by definition they are incurable.

Most people with LTCs spend just a few hours per year with healthcare professionals and more than 99% of their lives managing their conditions themselves. As such, they need to become experts in their own health and will make all the day-to-day decisions which affect their own health. In terms of healthcare this means that the system needs to support individuals to develop the knowledge, skills and confidence to manage their own care.

People with LTCs and the organisations that support them, such as National voices, the Kings Fund and Richmond Group, make a compelling case for services which are better organised around their needs, and emphasise that despite a robust evidence base and compelling financial case, little improvement has occurred over the last 10 years.

In addition to better prevention and early diagnosis they ask that clinical treatment is linked with: 

  • Support for self management
  • Engagement in decisions about their care
  • Coordination of health and social care
  • Emotional, psychological and practical support

The Year of Care Partnerships provides a robust and reproducible approach using care planning as a ‘gateway’ to address all these issues for each individual living with one or more LTC.