The Department of Health has published a framework setting out the challenges for the wider health and care system in addressing comorbidities, and proposing a set of interconnected principles to consider in the design of systems and services to prevent and treat comorbidities.
Comorbidity is one of the most important issues facing health systems in the developed world today and the single disease approach is unable to address this problem appropriately. Patients with multiple long term conditions are becoming the norm rather than the exception and the number of people with comorbidities is set to increase in England from 1.9 million in 2008 to 2.9 million by 2018.
The framework identifies that there are at least two key populations with comorbidities requiring a different emphasis of action: those who have comorbidities mostly due to increased life expectancy and longer exposure to risk factors over time; and those who have comorbidities mostly from more intense exposure to risk factors, particularly smoking, obesity, alcohol and physical inactivity due to challenging personal, occupational and societal factors throughout the lifecourse including persistent and widening inequalities.
The framework sets out 7 principles of action on comorbidity, including developing services that promote self management and shared decision making. It includes best practice examples across these principles, including National Voices Care and Support Planning Guide for patients.
The framework can be viewed here.