Multiple Conditions: Living Well in Localities

Multiple Conditions: Living Well in Localities

Long term conditions are a major challenge to health and care systems across the world whether in high, middle or low income countries.

The consultation on the WHO strategy for people-centred and integrated health services was launched in Edinburgh in March 2015 at the 15th International Conference for Integrated Care.

Many more people are living with more than one long term condition than ever before.

Many Conditions One Life is an Action Plan to improve the quality of support and services for people who live with multiple conditions in Scotland. It builds on the changes we are making through the introduction of Self-Directed Support and the integration of health and social care to support people to live well at home or in their local community for as much time as they can and to have a positive experience of health and social care.

A series of presentations that illustrate the outcomes and impact of these actions in practice can be accessed at

Our advice note published in November 2014, has links to many other useful resources and websites.

Living Well in Localities

It is widely recognised that localities are the engine room of integrated care and support and the space where we will best engage and empower those who deliver and receive health and social care and support.

The Improvement Network for Integrated Care and Support engaged 450 people across Scotland in three Living Well in Localities Road Shows in May 2015.

These sessions built on the Locality Conversations report published in June 2014

Partnerships shared learning around their emerging locality arrangements. These are being pulled together as a Locality Story Board – examples can be found here.

The many improvement supports and resources shared at the Road Shows can be found here.

Anticipatory Care Planning

Anticipatory Care Booklet: Improving  Lives has been developed to support the spread of Anticipatory Care Planning now being embraced by GPs and their colleagues in primary and community teams. It describes the process from the perspective of the patient, carer and professional and illustrates the range of supports and interventions that people can be signposted to through Anticipatory Care Planning. Most importantly it describes the positive impact that Anticipatory Care Planning is having on people’s lives.

ACP Booklet

Links to a few of the real life stories from the booklet are set out below – click on the picture to view.

Further stories can be obtained by contacting Marie Curran, Improvement Lead for Intermediate Care:

        “I can breathe again”                       Using the Key Information Summary             What a difference to have an ACP in place

I can breath again           Key Info Summary                   What a diff

For further information on the Multiple Conditions Action Area contact:   Dr Anne Hendry, National Clinical Lead for Integrated Care: