Plan to boost long-term ill care

Arthritis care is covered by reforms

An overhaul of care offered to people with long-term conditions such as asthma and diabetes has been unveiled.

Health Secretary John Reid said the aim was to improve quality of life, prevent premature death and minimise the need for emergency hospital visits.

Community matrons will be deployed across England to offer the most vulnerable patients one-to-one support.

However, the British Medical Association fears they could simply duplicate the efforts of GP practices.

Improving the health and quality of life of the millions of people with long-term conditions is a key priority. John Reid

The NHS is committed to having 3,000 community matrons in place by March 2007. Their role will be to monitor patient's health and co-ordinate the care and support they need for a better quality of life.

More than 17.5m people in the UK have long-term conditions such as arthritis, diabetes and asthma which can be controlled, but not cured.

Not monitored

In many cases these conditions go unmonitored and unmanaged until a hospital visit becomes necessary.

The new guidelines issued by the Department of Health are designed to ensure as many people as possible receive structured care.

The NHS is working towards a target of reducing by 5% the number of beds used by emergency in-patient admissions over the next three years.

The new measures are also expected to cut costs for primary care trusts and free up GP appointments - 8% of which are taken up by people's long-term conditions.

The new plans include the establishment of local teams of health workers who can identify people with serious long-term term conditions, assess their needs as early as possible, and provide pro-active care before their condition deteriorates.

There are also plans to educate all people with long-term conditions about their health and encourage them to manage their own care more effectively.

John Reid said: "Improving the health and quality of life of the millions of people with long-term conditions is a key priority for NHS and social care organisations.

"We must provide uniformly excellent care close to home for people who are often vulnerable and in pain."

A National Service Framework for long term conditions will be published later this year.

Doctors upset

If the idea of community matrons is going to work, they have to be fully integrated into primary care. Dr Hamish Meldrum

Dr Hamish Meldrum, chairman of the BMA's GPs Committee, said many family doctors would take exception to the suggestion that people with long term conditions went unmonitored and unmanaged.

He said there was a danger that community matrons would simply duplicate the work that was already being carried out in the primary care setting.

"If the idea of community matrons is going to work, they have to be fully integrated into primary care, working with general practice and not at cross purposes."

The Patients Association said the plans, if properly funded, could a significant step forward.

Katherine Murphy, director of communications of the Patients Association, said: "There will clearly be times when hospital is best, but a skilled community matron, with a long term knowledge of individual patients' needs, would be worth her weight in gold to those for whom pain management and limited ability to cope with activities are a daily occurrence.

"However, the NHS clearly has to study each case individually, to ensure decisions are not made for financial reasons."

Paul Burstow, for the Liberal Democrats, said the announcement would come as "cold comfort" for people living with long-term medical conditions.

He said: "A whole Parliament has passed and we are still waiting for the government to change the way the NHS works so that it fits around peoples' lives rather than forcing them to fit their lives around the NHS."