Long-term conditions
A long-term condition can affect any aspect of a person’s life. Often there is no cure, but steps can be taken to maintain and improve quality of life. Due to an ageing population, the number of patients with long-term conditions is expected to double over the next 25 years. Long-term conditions account for 80% of GP consultations and 60% of hospital bed-days.
Diabetes
Diabetes is on the rise in Scotland and we aim to improve the management of type 1 diabetes in young people. Our report, following an audit of the SIGN guideline published in 2001, looks at care strategies being used to maintain good glycaemic control in those with diabetes to minimise the risk of complications.
The resulting information gave each clinical centre a better understanding of their performance against the guidelines on glycaemic control.
We found that:
- Glycaemic control remains unsatisfactory in children and adolescents, with a high proportion falling outside the targets set out in the Guidelines.
- And the use of an intensive approach to insulin therapy is limited, despite evidence that this clinical strategy is the most effective method of improving glycaemic control and reducing the risk of long-term complications.
Asthma
patient experience- “My asthma consultant at Yorkhill Children’s Hospital was really cool – he understood
my needs and treated me as an individual. He knew everything there was to know about my condition and all the latest treatments that could help me. With check-ups every six months for the last six years, the regular care I received from staff at Yorkhill has played a huge part in helping me to control and understand my asthma.”
Richard Humphries
In partnership with the Scottish Executive Health Department and Asthma UK (Scotland), we promote the use of personal asthma action plans among people with asthma, particularly young people. The plan provides personalised guidance on the action to take when asthma symptoms worsen and is a written record agreed by a person with asthma and their healthcare professional.
Guidance for adults helping a child who suffers an attack is distributed to GP surgeries, chemists, schools, nurseries and playgroups throughout Scotland and our collaborative work with NHS Education for Scotland resulted in 350 nurses receiving training in specialist asthma care.
We have identified limited available data that suggest that there are currently some important deficiency in the management of acute asthma in emergency departments, particularly in respect of illness assessment and the planning of the patient’s discharge.
Our computer-based asthma education programme was developed to address this, and we have also found it practical to deliver asthma education to families of children with acute asthma during the short period they spend in the emergency departments.
Initial data points towards improvements in asthma care and reduction in asthma morbidity in the months following attendance at hospital. The stage is now set for a more formal objective assessment of the programme’s impact on asthma outcomes.
We asked children and young people to give us their thoughts and opinions on how they would like their asthma to be managed. And these were included in the standards which performance will be reviewed against across NHSScotland in 2007–2008.
Hepatitis C
To help the growing number of people with hepatitis C, we published a SIGN guideline on its management. The guideline provides evidence-based recommendations covering all stages of the patient care pathway: screening, testing, diagnosis, referral, treatment, care and follow-up of infants, children and adults with, or exposed to, hepatitis C infection.
We recommend increased testing for the virus among groups who are at risk of contracting hepatitis C, including current and former injecting drug users. And continuing the current practice of testing every blood or tissue donor, patients on haemodialysis, and healthcare workers who intend to pursue a career in specialties that may bring them into contact with the virus.
Further reading
Access SIGN’s Diabetes related guidelines
Access SIGN’s Hepatitis C related guidelines