GPs demand investment to cope with rising multimorbidity

GP leaders have called for better funding for generalist care after a report warned that most health services worldwide - including the NHS - are 'not designed to care for patients with multiple illnesses'.

The report from the Academy of Medical Sciences argues that rising levels of multimorbidity are likely to increase pressures on health systems and budgets worldwide and calls for more work to understand its impact.

Multimorbidity could affect between 13-95% of patients globally - a range described by the academy as ‘so wide that it indicates just how little is known about this global burden’.

The warning about the impact of multimorbidity comes just a month after GPonline reported that more than half of GP consultations in England are for patients with multimorbidity. The BMA has warned that these consultations cannot be handled safely within a 10-minute timeslot.

Barriers to care

RCGP chair Professor Helen Stokes-Lampard said GPs often found themselves 'coming up against barriers' to care for patients with multimorbidity.

‘A lack of research, as this study highlights, into the extent of the crisis is one,' she said. 'Another is understanding how best to treat patients living with both physical and psychological conditions – and having access to the most appropriate services to manage this in the community.’

The RCGP chair said care outside general practice was often focused on single-disease conditions, leaving GPs to manage much of the workload for patients with multiple illnesses.

She said: ‘It’s testament to the NHS that more of our patients are now living longer, but with an ageing population also comes more complex, chronic illnesses, and GPs are certainly seeing more of this every day on the front line.’

Long-term conditions

The college’s own analysis has shown that the number of people living with more than one serious, long-term condition in the UK will increase by nearly 1m to 9.1m by 2025.

GPC chair Dr Richard Vautrey said: ‘Patients with multimorbidity have a high treatment burden in relation to understanding and self-managing their conditions, attending multiple outpatient appointments and managing complex drug regimes.

‘The government must address the growing level of demand by providing more support for generalist care and deliver the investment required. This will allow for the necessary longer consultations and increased capacity to deal with the many problems patients with multimorbidity face.’

 According to the Academy’s findings, health conditions that frequently group together include heart disease, raised BP, diabetes, cancer, depression, anxiety, COPD and chronic kidney disease.

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