The management of long-term conditions

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Part of Inquiry into the quality of general practice in England

The proactive management of people with long-term conditions, including the promotion of self-care by patients, is a key priority for the NHS. General practice has a central role in delivering more integrated and personalised care, and in implementing policies that target 'at-risk' individuals with appropriate interventions.

Related document: Managing people with long-term conditions

What did we explore?

To inform its work, the Inquiry panel commissioned a research project to examine what constitutes best practice in managing long-term conditions, and how can this be measured. Managing people with long-term conditions, assesses the scope for significant quality improvements in this aspect of general practice care, with a specific focus on arthritis, diabetes, dementia and depression. The paper is written by a team from The King's Fund: Nick Goodwin, Natasha Curry, Chris Naylor, Shilpa Ross and Wendy Duldig.

What have we learnt about the management of long-term conditions?

In March 2010 the Inquiry held a seminar on the management of long-term conditions with participants including GPs, practice nurses, NHS executives, health academics and patient representatives.

Key issues raised in discussion include:

  • How general practices can be more proactive in the management of people with long-term conditions in local communities.
  • How to ensure that general practice has access to staff with the multi-disciplinary skills necessary to manage complex patients effectively.
  • What approaches can be used in general practice to better support patients to self-care.

What's your view?

During the inquiry, we asked for your opinions on this care dimension. You can read the comments submitted below.

Related content



Comment date
14 June 2010
As someone with long term mental health problems (depression), I have found that GPs have an extremely variable knowledge of treatments available. My last GP seemed to choose medication at random and never suggested any other treatment. My new GP is able to choose medication based on it's likely effectiveness for me, and has offered other treatment e.g. hypnotherapy cds and a mood support group. Now, feeling well supported, I just feel sorry for those still seeing ,y old GP. Having moved around the country a bit I have had several GPs who's knowledge falls somewhere in between these two. If GPs can't hold the necessary knowledge then access to specialist services should be quicker and easier.


the patient-centred healthcare blog
Comment date
21 September 2010
This report highlights again the need for strongly integrated care on 'chronic care model' lines. The government's White Paper proposals create two apparent contradictions. First, GPs are given the budget to commission services; but local authorities are given the legal duty to ensure such services are integrated. Second, while emphasising the desirability fo integrated care, the government will encourage further fragmentation by demanding the creation of local markets in whcih providers compete with each other to eb chosen by 'consumers'.

Sue Leggett

Comment date
29 September 2010
I have to agree with what was said in the report. Having RA myself and several other things going on, I definately think there should be integrated and personalized care. I have had experience of bad care and there isn't a helpline in place either to contact when you have a problem. If you ring the nurse or secretary and leave a message that needs an urgent reply they don'yt even bother ringing back. As RA is a very up and down disease which can't be predicted Ithink it's even more essential for a good service to help patients cope.