People with multiple long-term conditions (MLTC) face complex and uncertain hospital care journeys
AGE Research Group members are pleased to announce the publication in BMC Medicine of two complementary papers from the ADMISSION Research Collaborative. These papers highlight the dual challenges of delivering and receiving care for MLTC in the hospital setting, drawing on thematic analyses of the perspectives of 44 people living with MLTC and 40 healthcare professionals to provide a comprehensive view of MLTC hospital care in the UK.
In the first publication, a qualitative study of people living with MLTC who had experienced a recent inpatient stay in an NHS hospital (led by Sue Bellass, Ageing, Sarcopenia and Multimorbidity (ASM) theme, NIHR Biomedical Research Centre (BRC): Newcastle), a persistent tension between acute and chronic care provision, with hospital care routines often not flexible enough to respond to long-term condition self-management practices was revealed. In parallel, a qualitative study of hospital healthcare professionals making front-line clinical decisions for people with MLTC (led by Sara Pretorius, NIHR HealthTech Research Centre in Diagnostic and Technology Evaluation (HRC DTE)) highlighted the adaptive decision-making strategies needed to compensate for the uncertainty inherent within the system.
Taken together, these findings highlight the impact of resource constraints on the provision of holistic care, the inflexibility of hospital systems to respond to self-management practices, uncertain care pathways, the complexities of clinical decision-making and the misalignment between single-condition models of care and the needs of people living with MLTC.
The studies exemplify the value of partnership working across NIHR infrastructure, leveraging the benefits of qualitative methods expertise within the NIHR BRC: Newcastle and the HRC DTE to deliver wide-ranging insights into the lived experience of MLTC hospital care which can inform the design and delivery of coordinated service provision.
Recruitment of the diverse samples for both studies benefitted from collaborations with universities and NHS Trusts across England, including Newcastle upon Tyne Hospitals NHS Foundation Trust, the Northern Care Alliance, Gateshead Health, the University of Birmingham and University Hospitals Birmingham NHS Foundation Trust. The ADMISSION research collaborative was funded by the UKRI-NIHR Strategic Priority Fund ‘Tackling multimorbidity at scale’ programme (grant number MR/V033654/1).
The full text of the articles can be accessed here: