Agenda item

Mark Pierce, Senior Strategy and Implementation Manager, Leicester City Clinical Commissioning Group and Jeremey Bennett, Strategy and Implementation Manager, Leicester City Clinical Commissioning Group to give a presentation on an overview of multi-morbidity in Leicester.

Mark Pierce, Senior Strategy and Implementation Manager, Leicester City Clinical Commissioning Group and Jeremey Bennett, Strategy and Implementation Manager, Leicester City Clinical Commissioning Group gave a presentation on an overview of multi-morbidity in Leicester.

During the presentation Members noted:-

·         Multi-morbidity was commonly defined as the presence of two or more chronic medical conditions in an individual and it could present several challenges in care; particularly with higher numbers of coexisting conditions and related polypharmacy.

·         Initiatives were being delivered to begin addressing these challenges both nationally and locally.

·         Social Isolation was also a growing concern, and it did was not an issue that could be solved in isolation by the NHS.

·         There was increasing awareness that addressing it had a positive impact on a person’s ability to keep well and Age UK, in partnership with the CCG and Public Health; had developed a service to tackle loneliness that has already seen significant levels of referrals from City GP Practices.

·         One-in-four adults in England were now living with two or more health conditions, (approximately 14.2 million people nationally) and half of all primary and secondary care consultations and admissions were for multi-morbid patients.

·         The number of people living with multiple health conditions was expected to rise significantly during the long-term plan period.  Both projected hospital activity and associated costs were expected to rise by 14% and £4bn over the next five years respectively.

·         Multi-morbidity was not just a problem of ageing, as approximately a third (30%) of people with 4 or more conditions were under 65 years old; and this was higher in areas of high deprivation.

·         The impact of living with multi-morbidity can be profound as people with multiple health conditions had poorer quality of life, difficulties with everyday activities and a greater risk of premature death.

·         Multi-morbidity presented the health care economy with the following pressures and challenges:-

o   higher costs and increased use of the healthcare system;

o   it is often associated with disability and the progressive need for support with activities of daily living;

o   the issue of multi-morbidity is increasingly becoming the norm for patients;

o   multi-morbidity results in more emergency admission costs than age per se;

o   multi-morbidity is increasingly distributed throughout the population and does not just occur in the elderly – 30% of emergency admissions to hospitals involve people of working age; and

o   not all patients with a particular long term condition are the same.  For example if people with diabetes were treated early and effectively this can considerably effect and slow down the escalation of their long term health.

During discussion the following comments were made by Board Members:-

·         The effects of loneliness can have the same impact upon a person’s health and wellbeing as tobacco and alcohol.

·         There was a need to re-examine commission strategies, particularly for those patients with 5-8 health conditions to improve their health to reduce hospital admissions and also to see how people with few morbidity issues can be supported to slow down the rate of their conditions deteriorating for longer.

·         The CCG were currently reviewing their commissioning of services with health partners to a joint commissioning service so the commissioners and providers of services could take a collective approach to commissioning and understanding the health needs of local residents and in addressing where commissioned services are not meeting those needs.

The Chair welcomed the opportunity to have a strategy that provided a holistic approach to the commissioning and provision of health services to meet local health needs, including more provision for mental health services.  She also welcomed the offer from the LLR Chief Executive for the CCG to address the Boar don the outcomes of their current discussion with partners to re-shape local commissioning and provision of services to a future meeting.

RESOLVED:             Officers were thanked for their informative and though provoking presentation.