Ministerial foreword

This National Service Framework (NSF) for Long-term Conditions marks a real change in the way health and social care bodies and their local partners will work with people with long-term conditions to plan and deliver the services which they need to make their lives better.

The NHS has a tremendous record in saving lives and combating illness. Deaths from cardiovascular disease and cancer have fallen by 27% and 12% respectively (i). But that is not enough. For many people living with conditions such as multiple sclerosis or Parkinson’s disease the main issue, until science can find a cure, is improving the quality of their lives, supporting them to manage their symptoms and live as independently as possible. We now need to build on what the NHS and social services have achieved and develop services which can respond better to the needs of this group of people. The NHS Improvement Plan: Putting People at the Heart of Public Services sets a new strategic model for management of long-term conditions through self care, disease management and case management. This NSF is a further demonstration of the priority health ministers attach to improving the lives of people with long-term conditions by:

• giving people choice, through services planned and delivered around their individual needs;
• supporting people to live independently and play their full part in society;
• co-ordinating partnership working between health and social services and other local agencies.

This NSF also builds on Supporting People with Long Term Conditions – An NHS and Social Care Model to support local innovation and integration, which introduces new management arrangements for transforming service delivery for people living with long-term conditions. The NSF aims to make this new approach a reality for people living with long-term neurological conditions. It is a very important step in delivering this strategic shift in the way in which health and social care organisations work together to support people with long-term conditions.

The NSF focuses on neurological conditions and its quality requirements are based on evidence from services for people with neurological conditions. But that focus on neurology highlights and sets in clear context issues which are also relevant to the millions of people living with other long-term conditions such as arthritis. For instance, in showing the difference which can be made by putting people with long-term neurological conditions at the heart of their own care, the NSF demonstrates the importance of the person-centred approach for everyone who uses health and social care services. Similarly, the evidence in the NSF about the value of improving access to assistive technology and of opening up palliative care for people with neurological conditions can also apply to other people living with disabilities and persistent pain.

Change cannot happen overnight. It will take time to train staff and develop new facilities and services. That is why we are giving commissioners and providers up to 10 years to implement fully the recommendations of this NSF. However, there are changes which can be made to bring improvements in the shorter term. The NSF Good Practice Guide we are providing for care service professionals, together with the report of the Modernisation Agency Action on Neurology programme, will provide practical help to transform services. We will ensure that everyone living with a long-term condition, and their families and carers, will be able to understand what help and support they can expect. Finally, we are working with the Health Care Commission and the Commission for Social Care Inspection to help them review and monitor service change.

John Reid

Secretary of State for Health

(i) Department of Health statistics supplied in January 2005 show that the death rate from cardiovascular disease in people under 75 years of age has fallen by 27% since the 1995–1997 baseline. The death rate from cancer in people under 75 years of age has also fallen by 12.2% compared with the 1995–1997 baseline.