New guideline to support older people with multiple long-term conditions

November 4, 2015

Last Updated on May 8, 2017

With millions of people in England living with more than one chronic health condition and hundreds of thousands more set to develop multiple conditions in the future, new guidance has been released to ensure care remains safe and of a high quality.

The guideline by the National Institute for Health and Care Excellence (NICE) focuses on the group of people most likely to be living with more than one long-term condition – older people. It says health and social care services should work more closely together to deliver effective services and improve quality of life for those they look after.

Reports have previously said that health and social care services for older people can often be disjointed and hard to access. The new NICE guideline for Older people with social care needs and multiple long-term conditions wants to help services from both sectors bridge this gap to achieve better, more effective ways of working.

The guideline makes a series of recommendations for people who commission, manage and provide care for older people with social care needs and multiple long-term conditions. These include:

  • Ensuring care is person-centred and that the person is supported in a way that is respectful and promotes dignity and trust.
  • Having a single named care coordinator for older people with social care needs and multiple long-term conditions.
  • Developing care plans in collaboration with GPs and representatives from other agencies that will be providing support to the older person in question.
  • Making sure there is community-based multidisciplinary support for the older person in question. Such a team may include, for example, a community pharmacist, physiotherapist and a mental health worker.
  • Supporting older people with social care needs and multiple long-term conditions to maintain links with their friends, family and community.

The NICE guideline also includes specific recommendations for care homes. These include: making sure people are physically comfortable and have a choice of things to eat and drink during the day which meet their nutritional needs; and building links with local communities, encouraging interaction between residents and local people of all ages and backgrounds.

It also supports the training of health and social care practitioners to help them develop the right skills and knowledge to do their jobs well.

Professor Gillian Leng, Deputy Chief Executive for NICE, said, ‘It’s estimated that as many as 6 million people in England aged 60 and over are living with more than one long-term health condition.

‘As the number of older people in society increases, the number living with long-term conditions will also rise. A recent report by Age UK noted that a further one million older people in England could be living with multiple long-term conditions by 2020. This will inevitably put pressure on health and social care services and our new guideline highlights ways to best address the growing care needs of this group.’

Bernard Walker, a Liverpool-based independent consultant in social care, health and management chaired the NICE committee which developed the guideline’s recommendations. He said, ‘When social care and health practitioners work together well, it helps both people using services and their carers to have choice and control over their care. It also avoids unnecessary duplication of services.

‘As a committee, which brought together a knowledgeable group of experts including practitioners, carers and people who use services, we recognised how critically important this issue is. Better integration of health and social care services is best practice to which everyone involved in the care of older people with complex care needs and multiple long-term conditions should aspire.’

Speaking on behalf of the British Geriatrics Society, Dr Andrew Williams said, ‘This is important and timely new guidance. With increasing numbers of older people living with multiple long-term conditions, it’s increasingly important that social care providers are able to recognise long-term conditions, and consider their impact when planning an individual’s care needs. Careful care planning and care coordination is key to delivering true patient-centred care.’

The guideline is available to download from the NICE website here.

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