‘NHS must adapt to multiple diseases’

UP to 20 million Britons are suffering from two or more serious health problems and the NHS needs restructuring to deal with them properly, according to a leading professor.

The number of people living with multiple long-term illnesses and dying prematurely is increasing, according to a report by the Academy of Medical Sciences, which suggests ineffective treatment is leading to early deaths.

“We are facing a tidal wave of patients living with multiple longterm health conditions, and our report demonstrates how little we know about how to manage this,” said Professor Stephen MacMahon, chairman of the Academy of Medical Sciences multimorbidity working group.

“Outcomes appear to be worse in these patients, and yet there is growing evidence that people with multimorbidity (several diseases at the same time) are less likely to receive appropriate care for the individual diseases they have.

“We face a situation where those in greatest need are least likely to receive appropriate care.

“For too long we’ve focused almost exclusively on the management of single diseases, such as cancer and HIV.

“This means we have neglected the reality that most people with any one long-term disease typically have others.”

The report was worldwide, but the situation in the UK suggests multimorbidity is “the norm”, according to Professor MacMahon.

An example given is the frequent co-existence of coronary heart disease and cerebrovascular disease – two similar diseases often found in the same person.

The report also shows physical and mental health conditions often cluster together and that poor mental health can negatively affect quality of life and life expectancy, more so than having multiple physical illnesses.

The division between health services treating mental and physical health often means patients suffering from both physical and mental conditions are at particular risk of poor care, according to the report.

Dr Lynne Corner, director of engagement at the Newcastle University Institute for Ageing and Faculty of Medical Sciences, said: “It can’t be a full-time job, being a patient.

“We can’t have five appointments in five days with five different teams in five different clinics.”

She cited the example of a pioneering CRESTA (Clinics for Research and Service in Themed Assessments) clinic in Newcastle where one patient is seen by multiple specialists in the same visit.

Dr Corner said: “We are seeing if we can roll them out more.”