Improving care for people with long term conditions: a review of UK and international frameworks


Elderly womanThe NHS and Social Care Model was developed based on examples of good practice in the UK and abroad. Other similar frameworks are being implemented throughout the world.

The NHS Institute for Innovation and Improvement has been commissioned to identify ways to help the NHS shift care out of hospitals and into significantly redesigned community based systems, focusing on the management of long-term conditions. This work will support the ongoing implementation of the NHS and Social Care Model and the Our Health, Our Care, Our Say White Paper.

As a starting point for this work, the NHS Institute wanted to compile up to date up to date information about other generic care models and the impact of these models. Therefore this report describes some of the key frameworks used to conceptualise chronic care in the UK and abroad and summarises evidence about the effects of these frameworks.

Our three key questions were:

  • What frameworks for people with long-term conditions have been used internationally?
  • What evidence is there about the impacts of these frameworks?
  • What approaches have been adopted by Strategic Health Authorities?

We defined a ‘framework’ as an overarching approach that describes the different elements needed to care for people with long-term conditions most effectively. We did not focus on

particular local interventions. Instead the focus was on ‘higher level’ strategic frameworks that outlined multiple interlinked components. The review describes frameworks for working with people with long-term conditions generally, rather than evidence about approaches to specific conditions.


This report reviews international models of chronic care and the approaches taken within the NHS.

The report describes the range of models adopted in different health care systems and by organisations like the WHO, and it reports the results of a survey of NHS organisations. The wide variety of approaches that have been used is highlighted as is the lack of good quality evidence on the impact of these approaches.

Full report - Improving care for people with long-term conditions (PDF)

Date: 2006
Researcher: Debbie Singh and Chris Ham

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