Shand, Jennifer;
Higginson, Irene;
Matthew, Hotopf;
(2024)
Reimagining Health and Care to Tackle the rising tide of inequity, multimorbidity, and complex conditions.
NEJM Catalyst Innovations in Care Delivery
10.1056/CAT.24.0266.
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Abstract
On September 24, 2024, academic, clinical, health, social and voluntary care, and national and regional political and governmental policy leaders will meet in London to discuss and shape the launch of the Better Health and Care Futures initiative led by King’s College London, with follow-up events across the United Kingdom. The attendees will be aware that the challenges that health and care systems face are complex, and they are not likely to surrender to simple solutions. There are no magic bullets. On the other hand, doing nothing will not be judged well by history. To provide focus and direction, Better Health and Care Futures comprises three clusters of activities that offer a thoughtful path forward: the need to Recognize and Foster a Wider, Inclusive Careforce; Prioritize Frugal Innovation; and Coproduce with Communities. This article summarizes the thinking behind these initiatives. Global health and care systems are under unprecedented pressures due to rising demand from increasing multimorbidity at all ages, demographic changes with aging populations, workforce shortages, barriers to patient access, post–Covid-19 pandemic illnesses, and fiscal challenges. Proposed solutions often overlook individuals with complex, multimorbid conditions, where burden and inequity are high, care is costly, and outcomes are suboptimal. Meeting the needs of these individuals is both a moral and practical necessity, as it would alleviate strain on health and care services, improve care value (i.e., patient-relevant outcomes relative to cost), and enhance lives. Doing so requires a new paradigm that goes beyond existing disciplinary-based approaches and disease-specific interventions.
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