Integrated care policy recommendations for complex multisystem long term conditions and long COVID

Area of Science:

• Health Services Research
• Public Health
• Clinical Medicine

Background:

• Integrated care for complex, multiple long term conditions was a challenge pre-pandemic.
• The COVID-19 pandemic and emergence of Long COVID necessitated rapid health service adaptation and redesign, including integrated care models.
• Existing challenges in integrated care were amplified by the need to address Long COVID.

Purpose of the Study:

• To identify integrated care priorities for Long COVID and complex, multiple long term conditions.
• To achieve consensus among patients and healthcare providers on these priorities.
• To propose a model for delivering integrated care to patients with complex multisystem conditions.

Main Methods:

• A UK-based Delphi consensus study involving 480 patients and healthcare providers.
• Data collection through surveys with over 1400 responses.
• Analysis of responses to determine consensus on integrated care priorities.

Main Results:

• Achieved an 80% consensus rate on integrated care priorities for Long COVID and complex, multiple long term conditions.
• Identified key resource allocation needs: supporting integrated care, ensuring access to effective treatments, personalized diagnostics, and structural consultation between primary and specialist care (physical and mental health).
• Recommendations were supported by patients, healthcare professionals, and patient charities.

Conclusions:

• Integrated care priorities for Long COVID align with those for complex, multiple long term conditions.
• A multidisciplinary team model is proposed for delivering integrated care to patients with complex multisystem conditions.
• These findings offer a foundation for improving integrated care internationally for these patient groups.