How should health policy respond to the growing challenge of multimorbidity?

University of Bristol | November 2018 | Experts call for health system change to tackle the challenge of multimorbidity in the NHS

A new report produced by the Universities of Bristol, Manchester, Dundee and Glasgow calls on policymakers to alter the health system to address the challenge of multi morbidity, where patients with one or more long-term health condition, are much higher users of both primary care and hospital services compared with the general population.

The research team’s hypothesis was that the patient-centred, so-called 3D approach (based on dimensions of health, depression, and drugs) for patients with multimorbidity would improve their health-related quality of life, which is the ultimate aim of the 3D intervention.The study is one of the largest ever trials of a person-centred approach to caring for patients with multimorbidity in primary care; it involved 34 practices in England and Scotland randmoly allocated to continue usual care (17 practices), with the remaining practices (16 practices)  to provide 6-monthly comprehensive 3D reviews, incorporating patient-centred strategies that reflected international consensus on best care.

To this end the researchers have produced the reeport ‘How should health policy respond to the growing challenge of multimorbidity?’. 

The report makes a series of policy recommendations including:

• Promoting patient-centred approaches to the management of multimorbidity in primary care, which requires training, support and changes in incentives.
• Developing and evaluating new approaches to managing patients with multimorbidity within hospitals.
• Exploring new models of integration of primary and community care, hospital care and social care which enable better coordination and support for people with multimorbidity, which is likely to require substantial changes in commissioning and funding mechanisms, and a rebalancing of resources.
• Changes to professional education, training, and regulation to prepare professionals to manage patients with multimorbidity in new and more integrated systems.
• Engaging and enabling people to manage their own health and long-term conditions, requiring coordinated action across many aspects of government and public life.
• More research to understand and improve care for multimorbidity. (Source University of Bristol)

Related: 

Read the full University of Bristol press release 

Easy to read summary [CLAHRC Bite]

The study has been recently published in The Lancet 

Read the NIHR Signal