Multi-morbidity has emerged as one of the greatest challenges facing health services, both presently and in coming decades. Improving outcomes for people with multiple long-term conditions is a priority.
The rapid ethnographic study led by Dr Maria Kordowicz from the School of Population Health & Environmental Sciences, in collaboration with Dr Dieu Hack-Polay at the University of Lincoln, explores how multi-morbidity (of physical and/or mental health conditions) is managed within Southwark and Lambeth, two diverse and densely populated boroughs in South London.
Building on previous work funded by Impact on Urban Heath as part of their Multiple Long-Term Conditions Programme, the research aims to provides insight into the role of community assets, such as charity, voluntary or community groups, in helping people living with two or more diagnosed chronic conditions and provides recommendations for future service organisation.
As we face one of the greatest public health burdens of all time in multi-morbidity, and our statutory services come under ever-greater strain, it was crucial to explore the role of community organisations in multi-morbidity care.– Dr Maria Kordowicz, School of Population Health & Environmental Sciences
The scoping work comprised of four micro-studies in order to investigate stakeholder and policy-maker attitudes towards community assets and their role in multi-morbidity, with the focus on providing a holistic overview, rather than on individual patient experience.
An analysis of previous research in the field highlighted the role of attitudes and understandings in the management of multiple-long term conditions and the need to move beyond silos in their management. On the other hand, an analysis of publicly available local policy documents highlighted a resource poor climate and an analysis of stories provided by patients in the community underline the lack of joined up care, and psychosocial issues such as the loss of control and reducing isolation.
In the final micro-study, an analysis of stakeholder interviews revealed, again, a sense of disjointed care in the boroughs, the need for holism in the understanding and treatment of multi-morbidity, whilst also recognising the important role of community-based approaches, and the need for person-centred care and support.
Our scoping study suggests that community organisations are viewed as assets for helping those with multiple long-term conditions, often seen as providing holistic support. However, they must be adequately resourced rather than used to deal with demand placed on strained statutory settings. There remains a call for joined-up services which do not deal with each chronic condition in isolation.– Dr Maria Kordowicz, School of Population Health & Environmental Sciences