New research reveals over half of adults in England have a long-term condition

New research from Future Health reveals the impact of long-term conditions and multiple long-term conditions in England. The analysis, The Forgotten Majority? a new policy framework for improving care for people with long-term conditions (Long Term Conditions Report FINAL DECEMBER 2023), commissioned by AbbVie, finds that over half of adults in England (56%), 25 million, now have a long-term condition.

The most prevalent long-term conditions are arthritis, back or joint issues, affecting nearly 1 in 5 people. High blood pressure, mental health and asthma/COPD all have high prevalence rates over 10%.

The report also reveals the growing impacts of multiple long-term conditions with nearly 1 in 4 (24%) people, 13.4 million, having more than one. The report was covered by the Sunday Express.

Four of the five health systems with the highest estimated rates of people with multiple long-term conditions are in the South West (Cornwall and Isles of Scilly, Somerset, Dorset and Devon) where over 27% of people have more than one long-term condition. By contrast health systems in London with younger populations have the lowest rates nationally with rates of 20% or lower.

The report finds that long-term conditions are having a major impact on the NHS. It is estimated that people with long-term conditions account for 50% of GP appointments – 16.3 million a month.  These conditions are significant contributors to the overall number of NHS hospital admissions. Annually there are 1.4 million admissions for gastroenterology, 800,000 for ophthalmology, 640,000 for urology and nearly 200,000 for neurology and rheumatology respectively.

Patients with long-term conditions cost healthcare systems more. The NHS estimates that a patient with a long-term condition costs three times more than a person without a long-term condition (£3,000 vs £1,000). Patients with two conditions cost £6,000 a year and those with three or more £8,000 a year. Based on this modelling the cost of long-term conditions and multiple long-term conditions is £115.2 billion a year.

The challenges of managing long-term conditions and multiple long-term conditions is resulting in patients receiving a mixed experience of care. Recent data from the Patients Association found that only a third of patients said their care had been well co-ordinated with a third disagreeing. 40% felt they had been kept informed about what was happening to their care, a third did not. Two in three patients struggled to access at least one of the services they needed.

The report argues that past policies on improving care for people with long-term conditions have had mixed results. The numbers of patients reporting that they are confident in managing their condition has fallen in recent years and the numbers of unplanned admissions for such conditions has been rising.

The report calls for a greater focus in the Government’s forthcoming Major Conditions Strategy on long-term conditions and multiple long-term conditions; the impact of these conditions to be reflected in workforce planning and resourcing; and reforms to the GP contract to improve the co-ordination of care around the needs of patients.

Richard Sloggett, Programme Director, Future Health and report author said: “This report highlights the growing impact of long-term conditions on patients, the health system and the economy. Billions of pounds is being spent in direct care costs and being lost economically as patients struggle to get the care they need. The Major Conditions Strategy needs to prioritise new approaches that join-up care more around the needs of patients and invests in primary care to support continuity of care and better preventative healthcare.”

Todd Manning, UK Managing Director, AbbVie UK said: “What this report makes clear is that improving care for all those living with long-term conditions must be central to solutions seeking to address NHS capacity and sustainability. We already have at our disposal many of the tools and best practice evidence needed to help these often-forgotten individuals live healthier lives and stay out of hospital. But without clear accountability to drive effective implementation, we are limiting what could be achieved for these individuals, the NHS and the economy more widely.”

Rachel Power, Chief Executive, Patients Association said: “We know from our work with patients that too many are currently struggling to access the care and support they need. Care in many cases is fragmented and un-coordinated. The Major Conditions Strategy represents an opportunity to re-design care around patients, building a much closer partnership between patients and healthcare professionals, and with the wider health system. As this timely report shows, more and more people in England are living with long-term and often multiple conditions. This changing experience of ill-health requires new models of care, with greater integration of services, improved partnership with patients and ongoing support. The funding and new service models, including more shared decision-making, for delivering this should be central to the final Strategy when published.”