title: Sample evaluation of caseload complexity in a community health-care NHS trust.
abstract: People diagnosed with a multiple long-term conditions and those with profound and multiple learning disabilities are the most intensive users of health and social care. In addition, around 30% of patients with long-term physical conditions also have a mental health problem. The close relationship between mental and physical health is reflected in the high frequency with which illnesses of both kinds overlap in an age of multi-morbidity. This study demonstrates that those with comorbid mental health problems show poorer clinical outcomes, lower quality of life and reduced ability to manage physical symptoms effectively. This also affects their capacity to engage in treatment and make decisions, which affects not only their care and treatment but ultimately their quality of life. The NHS Call to Action demanded improvement in the service provided to support the needs of people with long-term conditions. The scale of the impact of comorbid mental health problems on costs and outcomes suggests that developing services that respond more effectively to these needs should be a priority.
authors.affiliation: Lead Specialist Nurse for Safeguarding Adults and Mental Capacity, Birmingham Community Healthcare NHS Trust.
authors.forename: Anne
authors.initials: A
authors.lastname: McGarry
mesh_terms: D019090:Case Management / Q000458:organization & administration*; D002908:Chronic Disease / Q000453:epidemiology; D003156:Community Mental Health Services / Q000458:organization & administration*; D015897:Comorbidity; D005260:Female; D006801:Humans; D007859:Learning Disabilities; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000628:therapy*; D008875:Middle Aged; D011788:Quality of Life; D013222:State Medicine / Q000458:organization & administration*; D016896:Treatment Outcome; D006113:United Kingdom; D016526:Workload
keywords: Long-term conditions; Mental health; Multi-morbidity; Profound and multiple learning disabilities