Integrated and holistic care of Chronic disease
Finding new, sustainable and cost effective ways of managing people with long-term conditions is increasingly being recognised as the next big challenge for health and adult social care. Many people with long-term conditions have complex needs because they have more than one condition and need services across hospitals, general practice, community services and social care. However, many people’s experience is that care is fragmented is not integrated across different services.
This theme builds on the work of the pilot CLAHRC which evaluated improvements in care for a number of individual long-term conditions, including stroke, diabetes and kidney disease. We have two priorities:
- To evaluate new ways of delivering integrated care to people with multiple long-term conditions - study 1 involves a series of case studies of new services across health and social care organisations in the West Midlands.
- To evaluate new ways of improving patient well-being - study 2 looks at the primary care management of musculoskeletal pain and mental health for patients with long-term conditions.
Study 3 looks at how clinical skills can be improved in order to promote emotional and psychological well-being for patients.
Theme 4 Links
Theme Lead
Professor Jon Glasby, University of Birmingham
Partners
- Birmingham City Council
- University Hospitals Birmingham NHS Foundation Trust
- Sandwell and West Birmingham Hospitals NHS Trust
- Heart of England NHS Foundation Trust
- University Hospitals Coventry and Warwickshire NHS Trust
- South Staffordshire and Shropshire Healthcare NHS Foundation Trust
- Staffordshire and Stoke on Trent Partnership NHS Trust
- Stoke on Trent Clinical Commissioning Group
- North Staffordshire Clinical Commissioning Group
- Keele University
- University of Birmingham