Personalised care for long-term conditions

 Living with multiple conditions

Mary, aged 76, has diabetes, arthritis, and macular degeneration, and she’s feeling low. She recently lost her husband, Frank, who died after a long period of dementia. She cared for him devotedly for many years, but this occupied most of her time and energy and took a heavy toll on her health and wellbeing.

Mary’s GP reminds her to attend the local diabetes clinic. The specialist nurses are concerned about her test results and urge her to try to eat a healthier diet and take more exercise. Mary nods, but in her heart knows that this advice will be difficult to follow. Her knees are painful, her eyesight is deteriorating, the local shops don’t sell much in the way of healthy food, and she doesn’t feel confident to travel far on her own.

As populations age, increasing numbers of people live with ...

Patient engagement, autonomy, access to mental care services – the case for integrated care in Crete

Access to comprehensive primary care (PC) services is imperative to address the complex biopsychosocial needs of patients with mental illness and their families, while it holds the potential to safeguard mental health and enhance resilience in communities. Integration of mental health and social care services in primary care has not yet been achieved, while access to such services for the mentally ill is still hindered by patient-, provider- and system-oriented barriers. Improving service integration, quality and access requires active engagement of patients and families in the design and planning of services.

Interprofessional collaboration, interdisciplinary approaches and sound deliberative processes are only the start of initiating discussions to establish the needs of local communities. Mapping care paths, involving stakeholders and engaging in practice-based research are impeded by the organisation and design of care provision, including siloed processes and semantic ambiguity in establishing common ground. Academic centres ought to act as hubs ...