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Why we must prioritise treating long-term health conditions

We need to find inventive ways to help the 26 million people in the UK who live with chronic illness.

By Todd Manning

As parliament returns from recess and winter looms, NHS capacity and resilience will once again be firmly on the political agenda. Guiding our capacity-strained health service through the winter has become a recurring, and increasingly critical, annual challenge.

It’s clear there is no single solution to address the enduring tension between demand and capacity in the NHS. But by looking to an often-forgotten area – the management of long-term conditions – there is an opportunity to create impact now and into the future. Importantly, we already have the tools to do it.

There are more than 26 million people in the UK living with at least one long-term condition. For them, current delays in accessing care or appropriate treatment can mean disease progression, disability and reduced quality of life.

For the system and the economy, the impact is also vast. There are more than 2.5 million people missing from the UK workforce due to long-term sickness, and care for people with long-term conditions accounts for 70 per cent of all hospital bed days, and £7 out of every £10 spent on health and social care.

Given long-term conditions become more prevalent with age, the UK’s shifting demographics to an older population means this impact is likely to continue to grow. Projections from the Health Foundation estimate the number of people living with major illnesses in England alone will rise nine times faster than the healthy working age population as society ages.

Despite this, many long-term conditions are being left out of the political narrative and overlooked when it comes to national strategies seeking to address declining outcomes, system capacity and longer-term sustainability. 

The government’s recent Major Conditions Strategy is a case in point. Although a welcome step in improving patient care, it proposes only six condition areas and covers only 1.4 million of the 7.4 million patients waiting on the NHS referral-to-treatment list. What about the long-term conditions in areas such as ophthalmology, gastroenterology and dermatology, which account for just under 1.4 million patients?

Omitting other conditions is a missed opportunity. The scale of the impact these conditions have requires us to be bolder and consider how we can improve the model of care more broadly.

This doesn’t have to mean sweeping structural changes. Wider adoption of existing best practice for patient pathways, digital solutions and earlier access to appropriate treatment present an opportunity to prevent or slow disease progression and achieve faster and greater system impact.

In areas where AbbVie has expertise, we have supported work that models what this could mean in practice. In migraine, we have demonstrated how improving community disease management could result in up to 10,000 fewer unplanned admissions. Also, in dermatology, 48,000 hours of specialist time could be saved by adopting a virtual pathway for urgent skin cancer referrals.

Over the coming weeks, we’ll be consulting with patients and experts from the long-term conditions community about exactly what prioritisation for long-term conditions should look like. We hope that through this process, we can collectively set out the commitments necessary to better meet their needs and support the NHS to survive and thrive for the future – whatever the season.

[See also: Health data must be used in the public interest]