Resources for long term conditions
Resources to support delivery of the long term conditions programme:
- Research into occupational health-related musculoskeletal (MSK) provision within CCGs. Letter from Professor Peter Kay
- Atlas of Variation includes insights into how CCGs compare nationally and with areas that have a similar demographic
- The Long Term Conditions Year of Care Commissioning Programme Implementation Handbook is the main output of the Year of Care Commissioning Programme. It describes the experiences of five care economies working as part of the programme as they work towards developing capitated budgets for some patients and services
- NICE clinical guideline on multi-morbidity: Assessment, prioritisation and management of care for people with commonly occurring multi-morbidities. Evidence based recommendations for people with multi-morbidity, a tailored approach to care and frailty
- The Long Term Conditions Financial Modelling Tool can help organisations to understand the financial and/or activity implications for new models of care for people with long-term conditions across different cohorts of patients and settings
- Supported by NHS England and the Coalition for Collaborative Care, a group led by Plymouth University have developed a guide to commissioners on how to use metrics, measures and insights to commission person centred care
- The recovery, rehabilitation and reablement (RRR) simulation model, by Simul8 Healthcare, aims to improve the quality of care and outcomes for patients by delivering a seamless RRR service for acute admitted patients, based on their entire needs and not just their diagnosis
Making it happen: practical handbooks for clinicians and commissioners
We offer three handbooks which provide practical support for good long term condition management. They set out the required service components and draw on the latest research, best practice and case studies to show how this can be done. The handbooks are useful to clinicians designing services and commissioners.
- Risk stratification and case finding – how to segment a population and provide person-centred care to those most in need recognising resource constraints
- Personalised care and support planning – the key vehicle by which health and care professionals work together with patients and carers to meet their needs
- Multi-disciplinary team working – how health and care professionals work together to support people with complex care needs that have been identified through risk stratification and case finding