CO-ACTION

Other NDORMS teams

The Pharmaco-Epidemiology Group is also involved in this project leading the identification of high-impact MLTC groups and estimation of a risk prediction model.

External team

Collaborators from University of Southampton, University of Plymouth, NHS Hampshire and Isle of Wight Integrated Care Board, University of Manchester.

What is this project about and why is it important?

In the UK, around 7 million people are living with more than one long-term health condition. For many, this means daily life is shaped not just by one illness, but by the challenge of balancing and managing several conditions at once. Unfortunately, the way health and social care is currently set up often doesn’t meet their needs. Services are usually organised to treat one condition at a time, which can leave gaps in support. As a result, people can struggle to get joined-up care that considers their whole life — including their mental wellbeing, mobility, social connections and everyday independence.

The CO-ACTION project has been created to change this. Thanks to a £2.47 million grant, all teams involved are working together with patients, carers, health and social care professionals to find new ways of supporting people with multiple long-term conditions. The programme will run for 54 months from September 2024 and brings together a wide range of expertise — from nursing and medicine to health economics, allied health professions and patient leadership.

What will the project examine?

One of the ideas being tested is simple but powerful: offering people a detailed, personalised assessment of their needs and providing them with one consistent, trusted person to turn to. This person will act as a guide, helping individuals navigate different services — from GPs and hospital specialists to social care, community and voluntary organisations. By coordinating care in this way, the project hopes to make the system less confusing and more supportive for the people who need it most.

This approach will be trialled with 500 people across four sites in the UK. If the trial shows that it improves people’s experiences and outcomes, the team will work with national and local partners to explore how it could be embedded into everyday practice across the country.

What is our team doing?

WP1 – We supported Patient and Public Involvement and Engagement (PPIE) activities by providing guidance on integrating economic perspectives into engagement activities, ensuring that cost-related considerations are reflected in public-facing discussions.

WP2 – Using OMOP-mapped CPRD-HES data, we are examining how people use healthcare services in both primary and hospital care , and the costs associated with these. This includes prescription data, to understand patterns of medicine use and their cost implications. We have also conducted a focused literature review to better understand the broader costs and outcomes measures used to assess interventions on people with multiple long-term conditions.

WP3 – We will be conducting a cost-consequence analysis, including cost-utility analysis alongside the three-centre 1:1 randomized pragmatic controlled trial of a personalised multisectoral intervention involving 500 people with multiple long-term conditions and their carers.

WPs 4 and 5 – We will support the Implementation Strategies and Evaluation which will employ Normalisation Process Theory to develop a logic model for adoption. Dissemination and communication activities will target stakeholders through open access articles, community activities, conferences, and other creative strategies.

Being inclusive is a priority

A key priority for CO-ACTION is making sure that care works for everyone, including people who have often been under-served by existing systems. This includes individuals from low-income backgrounds, people from ethnic minority communities, and those who do not speak English as their first language. By listening closely to these groups and involving them in shaping solutions, the project aims to reduce inequalities in health and care.

Impact

The broader research team will work with national Applied Research Collaborations and Integrated Care Boards to ensure that what is learned can be shared widely and put into action.By focusing on the whole person, not just their individual conditions, CO-ACTION is paving the way for a new kind of care: personalised, inclusive, and sustainable. The ultimate goal is to help people with multiple long-term conditions live healthier, fuller and more supported lives.

Funded by

National Institute for Health and Care Research (NIHR) through their Programme Grants for Applied Research (PGfAR).

Project outputs

Work in progress, please visit later.