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Terms of Reference: Management of long-term conditions

26 March 2013

Long-term conditions are defined on the Department of health website as “those conditions that cannot, at present, be cured, but can be controlled by medication and other therapies. The life of a person with a LTC is forever altered – there is no return to ‘normal’.” Among the most common of these conditions are hypertension, asthma, diabetes, coronary heart disease, chronic kidney disease, stroke and transient ischaemic attack, chronic obstructive pulmonary disease, heart failure, severe mental health conditions and epilepsy.

The same source also records that in 2012 the Department of Health was ‘working towards developing a cross-government strategy’ on long-term conditions and sought public views on its content. In the event, the Department did not produce a long-term conditions strategy as the Commissioning Board was to assume this responsibility. It did, however, share the results of its work with the Board.

Treatment and care for people with long-term conditions account for seventy per cent of health and care spending, and over 20 million people in England are living with one or more long-term condition. The management of long-term conditions requires a strong degree of interaction between health, social care and other services and demands the treatment of patients within the community and outside acute hospitals.

The Health Committee has decided it wishes to examine the way in which the NHS and social care system in England supports people with long-term conditions and seeks comments on the following issues in particular:

  • The scope for varying the current mix of service responsibilities so that more people are treated outside hospital and the consequences of such service re-design for costs and effectiveness
  • The readiness of local NHS and social care services to treat patients with long-term conditions (including multiple conditions) within the community
  • The practical assistance offered to commissioners to support the design of services which promote community-based care and provide for the integration of health and social care in the management of long-term conditions
  • The ability of NHS and social care providers to treat multi-morbidities and the patient as a person rather than focusing on individual conditions
  • Obesity as a contributory factor to conditions including diabetes, heart failure and coronary heart disease and how it might be addressed
  • Current examples of effective integration of services across health, social care and other services which treat and manage long-term conditions
  • The implications of an ageing population for the prevalence and type of long term conditions, together with evidence about the extent to which existing services will have the capacity to meet future demand
  • The interaction between mental health conditions and long-term physical health conditions
  • The extent to which patients are being offered personalised services (including evidence of their contribution to better outcomes)

Although the purpose of this inquiry is to examine the effectiveness of service provision for people with any form of long-term condition, the Committee will also wish to review in particular services provided for patients with diabetes. This will inform the Committee’s general review of the subject.

The Committee will also review the definition of long-term conditions to examine how to provide more effective management of interventions necessary to bring about service change.

The deadline for submitting written evidence is midday on Thursday 9 May 2013.

As part of a scheme to encourage paperless working and maximise efficiency, Committees have been piloting a new web portal for online submission of written evidence. This is to advise that submissions to this inquiry will be via the web portal only.

Guidance on submitting written evidence