How to relieve pressure on the NHS

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As the NHS faces the challenge of improving care for the 15 million people with long-term conditions, one hope for improving health outcomes while balancing the books is to shift from a reactive health care system that treats people when they become ill, to a proactive one that co-ordinates care and supports people to stay well. The Wanless report said as much in 2002, but progress towards this goal has been painfully slow.

The need for this shift is acute for people with long-term conditions who use at least 50 per cent of all GP appointments, 64 per cent of hospital outpatient appointments and 70 per cent of inpatient bed days, accounting for £7 out of £10 of health care expenditure. The growing number of people with more than one long-term condition – projected to rise from 1.9 million in 2008 to 2.9 million in 2018 – poses a particular problem. The Department of Health has calculated that this could add an additional £5bn to NHS costs unless better ways can be found to organise services.

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