“Just one thing after another”: Living with multiple conditions

Featured article - 26 April 2019
By Eve Riley, Programme Manager, Taskforce on Multiple Conditions

Nurse and man

It is estimated that between 15%-30% of the population in England live with two or more long term conditions, yet systems and services across the public and voluntary sector are often geared up around single conditions.

People with multiple conditions have poorer health outcomes, poorer experiences of care and are more likely to report care coordination problems. In the words of Keith, one of the participants in our recent research study, living with multiple conditions can be “just one thing after another”.

The Taskforce on Multiple Conditions aims to bring the voice of lived experience to this discussion.

Our most recent report explores the day to day impacts for ten people in England. The people featured in the report range from 24-year-old HR professional Anna in Somerset, to 71-year-old Godfrey, a retired factory worker who lives in Lambeth. Combined, they represent a total of 37 different conditions, including diabetes, depression and HIV.

It’s striking that people didn’t speak in terms of their individual diagnoses – they instead spoke movingly about the compound impact to their lives. We hear about missed opportunities to intervene; the series of losses – biomedical, relational or psychological – that add further complexity to ill health, and the accumulation of further illnesses; alongside the treatment burden of a fragmented system.

Repeated themes

And it is important to note that much of the unmet need was not medical. People were describing challenges with their mobility, diminished social connections, the impact to their personal relationships, work, finance and overall emotional wellbeing. We see how cross-cutting impacts such as chronic pain and fatigue can be more of a daily struggle than individual diagnoses. These were repeated themes that are evidently interdependent and can be mutually negatively reinforcing.

A better understanding of the journey and challenges people face helps us identify opportunities to act and explore interventions and initiatives that could slow down progression, helping people live better for longer. Very small interventions can make a significant and positive difference to people’s lives.

If we want to advance an agenda for a more patient-centred approach to health and care that consciously works around peoples’ needs and individual preferences, then supporting people with multiple conditions seems to be an important place to start.

To find out more, contact Eve Riley, Programme Manager, Taskforce on Multiple Conditions everiley@macmillan.org.uk.

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