Getting the basics right – providing good care for people with long term conditions

“I ended up in a number of hospitals all over the country, often far away from family and friends. It was a different place each time and having to constantly start again, telling my story to new doctors and trying to build up trust, was really tough.”

Nikki, 17, Surrey

It seems the NHS and its need for reform and ‘change’ are never out of the news. In the run up to the election, and in the midst of ongoing structural reforms, it can be easy to lose sight of what really matters: Enabling people to live as well as possible through joined up and holistic care.

There are at least 15 million people living with at least one long-term health condition in England today, and £7 in every £10 spent on health and social care is spent on managing these conditions. This amounts to a staggering £75 billion per year. Long-term conditions account for 70% of hospital bed days and half of all GP appointments.

70% of hospital bed days

The Richmond Group of Charities, the coalition of 10 leading health and care charities representing people with long-term conditions, has pooled the data its members hold about how patients experience their care. Whilst there is undoubtedly a great amount of good care going on, our unique perspective and evidence sadly shows that all is not well.


The Richmond Group report published this week ( doesn’t just highlight the all too common gaps in good care, but also shows that what would make the biggest difference largely does not depend on major reorganisations. It involves getting the basics right, such as:

  • Preventing illness wherever possible, or diagnosing and intervening early to prevent complications
  • Supporting people to manage well, through good information, care planning and shared decision making
  • Joining up services around the person’s needs, be they medical, emotional or practical, including the needs of people who care for others.

Over the next five years the real test of the Government and NHS leaders at all levels of the system will be whether the actual experiences of people using the services change, and the gaps we highlight in our report become a thing of the past. This is the benchmark by which the Richmond Group will be judging their success.

Dr Charlotte Augst – Richmond Group Partnership Manager (

“A diabetes education course gave me the first opportunity to really understand my condition and make decisions about all aspects of my life in a realistic way. This gave me the opportunity to regain the reins and left me in charge of my condition, rather than diabetes being in charge of me.”

Nick, 29, Cheshire

heart and cancer


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