Management principles for long term conditions

Managing long term conditions has been given a priority in all four UK countries

Managing long term conditions is a priority due to the desire to provide high quality services for people suffering with these conditions, and partly due to the cost implications of ineffective management. Although specific policies within countries are slightly different many of the principles are the same. These include:

• Quality

  There has been a change of focus in recent years towards delivery of high quality care rather than focusing exclusively on the speed of delivery.

• Efficiency

  Since the economic downturn both health and social care services are being called upon to deliver high quality, cost efficient services. NHS spending in the UK has increased over the last 60 years in real terms, so there will need to be a change in culture, even without funding cuts.

• Prevention

  Prevention of illness through the promotion of healthy lifestyles. High mortality rates in the UK tend to be related to illnesses caused by lifestyle factors (e.g. smoking, diet, lack of physical activity), rather than to infectious or communicable diseases, hence the priority now given to health promotion.

• Early diagnosis

• Responsive, accessible, flexible services

  There is a drive to ensure services are designed to meet the needs of people with long term conditions, rather than people being required to fit in with what the service can provide. When developing policy and guidance, emphasis is placed on engaging with ‘service users’ and the public to inform this. Responsive services often feature multi-disciplinary teams, particularly in rehabilitation settings.

• Joint working

  Particularly between health and social care. Many policies also advocate developing and using links with third sector organisations.

• Information provision and self management

  Many people are able to manage their condition provided they are given the information they need and they are able to consult with relevant healthcare professionals when necessary. This strategy is promoted since it helps to target intervention to where it is most needed and it helps people to have more control over the care they receive.

• Prevention of unnecessary hospital admission

  through proactive management. Also, ensuring timely and co-ordinated discharge from hospital

• Quality of Life

  Promoting quality of life/living well with a long term condition and promoting high quality end of life care (where conditions are life limiting)

• Carers

  Acknowledgement of carers and their role in allowing people to be cared for at home.

• Health and social care workforce

  Striving to develop an effective health and social care workforce which intervenes on the basis of competencies rather than on professional boundaries.

 
Occupational therapists have a key role to play in this agenda, and have many of the skills needed to deliver on the principles outlined above, because OTs consider the person, their environment and his/her occupational performance in that environment.
 
Occupational therapists help the person optimise independence in activities of daily living and develop and maintain vocational and leisure skills in their environment.
 
Occupational therapists also have the skills to deliver on other important principles, such as health promotion, inter-agency working, delivering person centred care and, where possible, preventing hospital admission.