NICE guidance and the importance of considering multimorbidity

Amit Arora is a consultant physician in care of older people and Chair of the England Council of the BGS. 

Finally, multi-morbidity may be recognized- is this wishful thinking or a BGS victory for our patients?

Whatever it is, it is time for action!

NICE is committed to developing more relevant guidance for GPs that takes into account the complexity of patients they see in daily practice with multiple long-term conditions, the chief executive of NICE told delegates at Pulse Live.

Opening the first day of the conference in London on 29^th April 2014, Professor David Haslam said NICE recognized current single-condition guidance was impractical for GPs dealing with patients with multimorbidity. ‘Single long-term conditions – which is the way NHS is organized generally apart from primary care – is the rarity.’ This of course is a cause close to the hearts and minds of many geriatricians. I have myself written about this on this blog and in some submissions to the health agencies in past.

Year of Care Explained

By Eileen Burns and Amit Arora

Payment by results (PbR) never fully addressed the management of long term conditions, and the importance of timely and seamless transition to and from the community for patients who live with them.

Year of Care (YoC) was suggested as a possible solution in 2011 by Richard Murray, Chief Economist at the Department of Health in his document, “Payment reform in the NHS”. The long-term conditions YoC tariff is designed to allow health and social care to be provided based on a person’s overall needs as opposed to what specific diseases they have. It fits with the work being undertaken across the NHS to make care better integrated. If it works as intended, it will allow funding to be moved around as needed to provide the most effective ‘package’ of care for the person over a 12-month period. The underpinning philosophy is that money should be present in the parts of the healthcare system best-suited to provide patient care. The financial model is based upon an annual risk-adjusted ‘capitation’ budget, based on levels of health care need.