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Responding to the needs of patients with multimorbidity: A vision for general practice

The provision of effective, person centred care to patients with multimorbidity is a key part of creating a modern 21st century NHS, and is a challenge in which general practice is very much at the forefront.

The number of patients living with multiple long-term conditions is increasing as a result of an ageing population, but also due to multimorbidity occurring earlier in deprived areas.

Patients living with multiple long-term conditions often receive a worse experience of the health and social care system. This can include not having access to services when they are most needed, consultations that are too short to discuss their multiple conditions, and fragmented care as a result of the disjointed approach of specialisms and services which are focused on specific diseases.

This occurs alongside burden of illness, where patients have to live with their conditions, often changing their lifestyle to do so. Patients also must cope with burden of treatment, which results from patients having to attend numerous appointments, and medication burden from complex medication regimens.

General practice plays a vital role in caring for patients with multiple long-term conditions. However, GPs are facing barriers in providing care to this patient group including a lack of research into multimorbidity, especially when physical and mental conditions occur together, complexities of polypharmacy, and incentives which are single disease focused. To address these barriers, it is essential that action is taken at GP practice, local health system and national level. This will support the cultural, clinical, contractual and organisational changes needed to improve outcomes for patients with multimorbidity.