Long-term conditions cost 'to soar'

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%VIRTUAL-SkimlinksPromo%The cash-strapped NHS may need to find an additional £4 billion every year to care for people with long-term conditions, MPs have warned.

The Health Select Committee said that these conditions are one of the "biggest challenges" facing the health service.
There is a rising tide of patients who suffer from long-term conditions such as diabetes, high blood pressure, depression, dementia and arthritis. At the same time the number of patients who suffer from more than one long-term condition is also rapidly increasing.

Caring for these patients currently accounts for around 70% of the NHS budget in England.

But the MPs warned that demand for services is currently exceeding funding available and the situation is only likely to "worsen".

Estimates suggest that the NHS spends around £1,000 a year treating someone with one of these health issues, someone with two conditions costs around £3,000 and a person with three will need NHS funding to the tune of around £8,000 a year.

And experts have said that the current figure of around 15 million people living with a long-term condition will rise by an additional three million over the next decade.

Dr Sarah Wollaston, who has recently become chairwoman of the powerful committee, said: "I think long-term conditions are one of the greatest challenges facing the NHS.

"In 2012 we had over 15 million people who were living with at least one long-term condition but by 2025 there will be 18 million. Already 70% of the entire health and social care budget goes towards looking after the 30% of the population suffering from these conditions.

"If you have one long-term condition, The King's Fund estimates that costs the NHS around £1,000 a year, if you have two it costs around £3,000 a year but if you have three it costs around £8,000 a year.

"What we're seeing is not only an increase in the numbers of people with long-term conditions but the number of people living with multiple conditions.

"Looking at the financial impact of that, it is estimated that compared to a baseline in 2010 the NHS is going to have to find £4 billion extra a year just to be keeping pace with that demographic change and the impact of multiple long-term conditions.

"We feel that there needs to be a much greater sense of urgency as to how we're going to deal with that, not only in financial terms but the impact on people."

In evidence presented to the committee, the Department of Health said: "Without changes to services, the costs of delivering care to people with long-term conditions will continue to increase.

"If there is failure to improve the prevention and management of care for people with long-term conditions it is estimated that by 2016 there will be an additional cost pressure on the NHS of around £4 billion p.a. (2010 baseline).

"The majority of this cost pressure comes from continued inappropriate and unplanned use of expensive acute hospital services."

And the situation could worsen in the two years following 2016.

The committee said: "Cost pressures on the health and care system deriving from management of long-term conditions and treatment of the increasing prevalence of co-morbidities is likely to add £5 billion to the annual costs of the system between 2011 and 2018."

The MPs said they support the integration of the health and social care system, but questioned the prevailing view that services to treat long-term conditions should be moved out of hospitals and into the community.

They said: "The focus on treating fewer people with long-term conditions in hospital is the wrong one: what the Government and NHS England should be addressing are the factors which drive people with long-term conditions into acute hospitals through A&E in the first place.

"Cutting acute services for long-term conditions without ensuring that primary and community care services were geared up to manage the care of people with long-term conditions would be a recipe for disaster."

The report also questioned the Government's pledge to put mental health on a par with physical health.

"What we have seen is NHS England using a tariff deflater that disproportionately takes money out of mental health budgets and we don't see how that is compatible with parity of esteem," Dr Wollaston added.

During the health reforms the responsibility for long-term conditions was transferred from the Department of Health to NHS England.

But the MPs said that this meant the cross-government strategy to combat such conditions was disbanded when the responsibility was handed over and called for clarity on cross-departmental handling of the problem.

A long-term condition is a health problem that cannot be cured but can be controlled by medication or other therapies.

Dr Martin McShane, NHS England's director for long-term conditions, said: "We have already taken steps to refocus the agenda on proactive care, especially for those most at risk and with complex care needs.

"We are already working on a number of wide-ranging initiatives including incentives for proactive care, work to support the frail and elderly and the integration of physical and mental health care.

"Local working will deliver the desired change but we do not underestimate the scale of the task and NHS England is fully committed to supporting person-centred care to enhance the quality of life for people with long term conditions."

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Long-term conditions cost 'to soar'
Mortgage rates are low at the moment, but even if you feel that your mortgage is a pretty good deal already, for a lot of borrowers there are better rates to be had. It's crucial to get the sums right – high upfront admin costs from a new lender or large early repayment fees from your existing mortgage provider could wipe out any savings. But, says David Hollingworth of brokers London & Country: "If you have an average standard variable rate (SVR) of 4.75%, a borrower with a £150,000 repayment mortgage over 20 years would pay £969.34 each month. Switching to a two-year fix with Norwich & Peterborough BS at 1.99% with £295 fee, free valuation and free legal work for remortgage would cut the payment to £758.11 a month, saving £211.23p.m." Over a year, that would mean a saving of £2,240, even with a £295 up front fee, and £2535 in following years.
Potential saving: £2,535
Your home and contents insurance may be costing more than it needs to. Gocompare.comdata shows that 25% of customers who provided their buildings and contents insurance renewal price saved up to almost £160 by changing to a new provider.
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With today's high cost of fuel, running a car is an expensive business. For a lot of people, particularly where public transport is sparse, giving up a car altogether is too big a challenge. But perhaps you could use it less, and take steps to bring down the cost of driving when it's unavoidable. The Energy Saving Trust says that just keeping your tyres pumped up correctly can save £31 a year, and turning off the air conditioning can save £77. Follow all the advice on the Energy Saving Trust's app, such as lift sharing and keeping your speed down, and the organisation claims you could save as much as £554 a year for a medium car covering medium mileage.
Potential saving: £554
If you haven't changed car insurer recently, the chances are you could save a lot of money by doing so now. According to research from Consumer Intelligence for Gocompare.com, in October 2013, 51% of consumers could save up to £242.55 by moving to a new insurance provider. There are plenty of comparison sites to try, including AOL Compare, so it really doesn't take long to find a cheaper deal.
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Start by finding out whether you could get a cheaper deal from a different energy supplier. If you haven't changed in the past, you probably can. According to gocompare.com, you could save around £309 a year just by switching to a cheaper deal (based on customers who switched energy supplier for both gas and electricity (dual fuel) using the Energylinx poweredGocompare.com platforms between 1 July and 30 September 2013).

Over the long term, there are plenty of ways to bring down bills that involve a relatively large outlay up front, such as ensuring your home is properly insulated. But just cutting your current energy use can have a huge impact on your energy bills. Some of the steps you can take are just a question of habit changing, such as switching appliances off instead of leaving them on standby. The Energy Saving Trust reckons the average household could save £50 and £90 a year just by unplugging or switching off at the socket. And turning down the washing machine temperature to 30 degrees, using a washing up bowl instead of leaving the tap running and only putting as much water in the kettle as you need can save you as much as £55 a year. Draught-proofing will save another £55, and proper 270mm loft insulation could save you up to £180 a year – taking into account the cost of fitting it the savings will take a couple of years to kick in.
Potential saving: £689 (far more if you take all the right steps in the home)
According to the NHS, most people who quit smoking save almost £2,000 a year. On top of that you get to feel healthier. What's not to love?
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Or at least, make your own. If you work in a town or city, the temptation to pop in and get a coffee can be strong. There's something comforting about sipping a hot coffee from those nice warm paper cups as you gear up for the working day. But if you stop to add up what it costs (including the cup), it may leave you cold. A Starbucks medium (OK, tall) latte costs £2.60 on the Strand in London. If you have one of those five days a week, 46 weeks a year (allowing for four weeks holiday), that means you are spending close to £600 – a tall price for a caffeine fix. If you make your own, a Bodum coffee maker costs £20 and a kilo of coffee costs around £13 and will make roughly 120 – 140. Missing the cup for the walk to work? Buy a Thermos mug for around £10. For £43, plus the price of milk, you can have coffee on the go all year round.
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It's a familiar scenario for many well-intentioned would-be gym bunnies. You sign up super motivated. You buy new workout gear, perhaps you work out regularly at the start. But then something – a holiday, a nasty cold, late nights at work – breaks your momentum and you stop going to the gym. Eventually your workout clothes lounge around in the cupboard while the gym keeps your bank balance trim by taking that direct debit each month. Gym memberships vary, but if you pay £80 a month for full membership, that's £960 a year's worth of good intentions. Invest in some proper running shoes – you can spend a fortune but specialist shop Run and Become has decent shoes for £50 – and hit the road. Need motivation? Download a free app such as Couch to 5k to get you started and track your progress as you get fitter.
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The range of mobile tariffs can be baffling. Many people end up on the wrong deal, perhaps paying for call time or extras they don't really need or use. There are a number of online tools and apps you can use to check your bill is not too high, such as Billmonitor and Mobilife. Enter your existing details and see if you could save money. In 2012, Billmonitor reckoned 26 million consumers in Britain were paying over the odds by as much as £164. The savings you could make will vary hugely, but it's certainly worth taking a look to see what you could save.

Apps like Viber and Whats App are also worth a mention as they allow you to text and call (Viber only) other users for free who have the apps on their smartphones. Whats App has ayearly subscription fee of around 65p, but the only other cost is the data on your smartphone plan if you're using 3G.

And when it comes to your broadband and home phone, it pays to find out if you are on the best deal. Dominic Baliszewski, telecoms expert at broadbandchoices.co.uk says: "Our own analysis has highlighted time and time again that a high proportion of customers do not actually switch broadband regularly enough to benefit from better pricing, which is crazy when you consider that switching can save you over £200 from your annual bill. Switching levels for broadband are woefully low when compared with energy or insurance services."
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In the UK, households throw away an estimated 25 meals each month, worth a total of £60 a month or £720 each year. Avoid buying too much food, even when it seems like you are saving money. Try not to 'take advantage' of bulk buy deals you may not use, make good use of your freezer for fresh foods rather than putting them in the fridge and forgetting them, and change a few of your shopping and eating habits and you may save money.

Make a list and stick to it. Shopping online can help you avoid temptation, and if you do your shopping on Mysupermarket.co.uk, you could save even more. Enter your items as you would on a supermarket site, and it will find the cheapest supermarket for your needs saving on average £17 a shop, according to the site. On a weekly basis that makes £884.

Growing your own vegetables can also save money, although the set up costs can be relatively high if you are starting from scratch. But some foods are cheap and easy to grow, even if you have little space. If you are in the habit of buying bagged salad, you could easily save a significant sum by growing your own. Jane Perrone, gardening editor of the Guardian and author of The Allotment Keeper's Handbook, says: "The materials to grow your own probably cost something shy of £20 a year, for seeds and compost mainly - I usually use recycled containers." A standard bag of salad from a supermarket costs around £1, so if you would usually buy one bag a week, you would spend around £52 a year.
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You might not be able to pay your credit card off straight away, but you can cut the cost. If your credit card has a rate of 18.9% and you have a balance of £5,000, then you could save £472 by doing a balance transfer to a credit card with a 0% introductory deal for the first six months.
Potential saving: £472
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