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Cost of treating long-term conditions set 'to soar' for NHS


The cash-strapped NHS may need to find an additional £4bn every year to care for people with long-term conditions, MPs have warned.

The Commons’ health select committee said long-term conditions were one of the “biggest challenges” facing the health service.

“What we’re seeing is not only an increase in the numbers of people with long-term conditions but the number of people living with multiple conditions”

Sarah Wollaston

There is a rising tide of patients who suffer from long-term conditions such as diabetes, high blood pressure, depression, dementia and arthritis. At the same time the number of patients who suffer from more than one long-term condition is also rapidly increasing.

Caring for these patients currently accounts for around 70% of the NHS budget in England.

But in a report published today the MPs warned that demand for services is currently exceeding funding available and the situation is only likely to “worsen”.

Estimates suggest that the NHS spends around £1,000 a year treating someone with one of these health issues, someone with two conditions costs around £3,000 and a person with three will need NHS funding to the tune of around £8,000 a year.

And experts have said that the current figure of around 15 million people living with a long-term condition will rise by an additional three million over the next decade.

Dr Sarah Wollaston, who has recently become chair of the influential committee, said: “Long-term conditions are one of the greatest challenges facing the NHS.

Health select committee

Sarah Wollaston

“In 2012 we had over 15 million people who were living with at least one long-term condition but by 2025 there will be 18 million. Already 70% of the entire health and social care budget goes towards looking after the 30% of the population suffering from these conditions.

“If you have one long-term condition, The King’s Fund estimates that costs the NHS around £1,000 a year, if you have two it costs around £3,000 a year but if you have three it costs around £8,000 a year.

“What we’re seeing is not only an increase in the numbers of people with long-term conditions but the number of people living with multiple conditions,” she said.

“Looking at the financial impact of that, it is estimated that compared to a baseline in 2010 the NHS is going to have to find £4bn extra a year just to be keeping pace with that demographic change and the impact of multiple long-term conditions,” she added.

“We feel that there needs to be a much greater sense of urgency as to how we’re going to deal with that, not only in financial terms but the impact on people,” warned Dr Wollaston, who is MP for Totnes in Devon and a former GP.

In its evidence to the committee, the Department of Health said: “Without changes to services, the costs of delivering care to people with long-term conditions will continue to increase.

“If there is failure to improve the prevention and management of care for people with long-term conditions it is estimated that by 2016 there will be an additional cost pressure on the NHS of around £4bn pa (2010 baseline).

“The majority of this cost pressure comes from continued inappropriate and unplanned use of expensive acute hospital services.”

And the situation could worsen in the two years following 2016.

In its report, the committee said: “Cost pressures on the health and care system deriving from management of long-term conditions and treatment of the increasing prevalence of co-morbidities is likely to add £5bn to the annual costs of the system between 2011 and 2018.”

The MPs said they support the integration of the health and social care system, but questioned the prevailing view that services to treat long-term conditions should be moved out of hospitals and into the community.

They said: “The focus on treating fewer people with long-term conditions in hospital is the wrong one: what the government and NHS England should be addressing are the factors which drive people with long-term conditions into acute hospitals through A&E in the first place.

“Cutting acute services for long-term conditions without ensuring that primary and community care services were geared up to manage the care of people with long-term conditions would be a recipe for disaster.”

The report also questioned the government’s pledge to put mental health on a par with physical health.

“What we have seen is NHS England using a tariff deflater that disproportionately takes money out of mental health budgets and we don’t see how that is compatible with parity of esteem,” Dr Wollaston added.

During the health reforms the responsibility for long-term conditions was transferred from the Department of Health to NHS England.

But the MPs said that this meant the cross-government strategy to combat such conditions was disbanded when the responsibility was handed over and called for clarity on cross-departmental handling of the problem.

A long-term condition is a health problem that cannot be cured but can be controlled by medication or other therapies.


Readers' comments (6)

  • michael stone

    I picked up on this one, on Radio 4: the CHSC's main point, was the insanity (my word - they were a bit more restrained) of reducing hospital services BEFORE making sure the extra community support is in place.

    I seem to recall, having made that point on NT before.

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  • increasing rationing on its way?

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  • We had the baby boom, hence the older person boom, not rocket science. Promoting a healthier lifestyle versus people living longer and having long term conditions, what do they expect? No forward thinking from the 50's/60's. Having said that the baby boom have contributed more taxes, etc., so where has the money gone?

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  • The Queen's Nursing Institute has also been making the same point about increasing the capacity of community nursing - including district nursing - for the past three years. Instead the number of district nurses has continued to decline throughout this period. We don't see any alternative to renewed investment in community services, if we are to provide high quality services that patients need.

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  • tinkerbell

    Dr Sarah Wollaston, Conservative Member of Parliament for Totnes - just saying!

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  • tinkerbell

    the moral maze on BBC Radio 4 last night basically asked should we have bean counters deciding on who gets what as the cost is rising or should we keep the founding principles of the NHS?

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