NICE multimorbidity guidance emphasises patient-centred care

_{Carley King: I would recommend all physios who treat people with two or more conditions to have a read}

The document covers how to optimise care for adults with multiple long-term conditions by reducing the treatment burden – where patients receive numerous drugs and multiple appointments – and unplanned care.

CSP professional adviser Carley King said: ‘This nuanced guideline takes quite a different approach to previous guidelines from NICE.

‘It’s really putting the emphasis on patient-centred care and I would recommend all physios who treat people with two or more conditions to have a read.

‘Also, it highlights a pragmatic approach to assessing frailty, and focuses on establishing patient preferences, values and priorities which is relevant to all.’

NICE says health professionals should consider using a clinical validation tool. These could include the electronic Frailty Index (eFI), the Predicting Emergency Admissions Over the Next Year (PEONY) tool or QAdmissions. Primary care e-health records can help identify markers of increased treatment burden, including the number of regular medicines a person is prescribed.

In separate guidance on social care for older people with multiple long-term conditions, NICE recommends discussing physical and mental health needs during an assessment.

This will ensure that all their health and social care needs are identified. It will also enable people to access the support they need to improve their quality of life and maintain their independence.

Ms King said: ‘The quality standard highlights physios as being one of the professions who should carry out a yearly review of the health and social care plan for older people with multiple long-term conditions.’

NICE acknowledges, however, that putting guidance fully into practice can take time. How long may vary from guideline to guideline, and depends on how much change in services is needed.

But implementing change is most effective when aligned with local priorities, it says.