Abstract
Little is known of how community assets can play a role in multimorbidity care provision. Using a rapid ethnographic approach, the study explored perceptions of the role of community assets in how multimorbidity is managed within Southwark and Lambeth in Southeast London, England. The scoping work comprised of four micro-studies covering (1) Rapid review of the literature (2) Documentary analysis of publicly available local policy documents (3) Thematic analysis of community stories and (4) Semi-structured stakeholder interviews. The data were analysed using framework thematic analysis. Themes are presented for each of the microstudies. The literature review analysis highlights the role of attitudes and understandings in the management of multiple long-term conditions and the need to move beyond silos in their management. Documentary analysis identifies a resource poor climate, whilst recognising the role of community assets and solution-focussed interventions in the management of multimorbidity. Community patient stories underline the lack of joined up care, and psychosocial issues such as the loss of control and reducing isolation. The stakeholder interview analysis reveals again a sense of disjointed care, the need for holism in the understanding and treatment of multimorbidity, whilst recognising the important role of community-based approaches, beyond the biomedical model. Recommendations stemming from the study’s findings are proposed. Upholding access to and resourcing community assets have key practical importance.
Highlights
This rapid ethnographic study is a research scoping exercise to examine the understandings of community assets and multiple long-term conditions (MLTCs) in Lambeth and Southwark, two densely populated London Boroughs
Findings are presented in turn for each of the four numbered microstudies with illustrative quotes to convey the salient ideas and beliefs captured through the thematic analysis
By utilising a rapid ethnographic approach and bringing together multiple data sources from a series of micro-studies, the study has provided an insight into some of the key themes surrounding MLTCs in Lambeth and Southwark and beyond. These two inner London boroughs have significant minority populations and pockets urban poverty; this makes the results of the study relevant to other urban settings which may present similar characteristics of urban multimorbidity and community assets
Summary
This rapid ethnographic study is a research scoping exercise to examine the understandings of community assets and multiple long-term conditions (MLTCs) in Lambeth and Southwark, two densely populated London Boroughs. The purpose of the study is to provide insight into community assets, multimorbidity and the dynamics of the relationship between them, harnessing learning and implications for health improvement. Multimorbidity is defined as the presence of several chronic medical conditions [1]. These may be related to physical and/or mental health. A long-term or chronic health condition is one which lasts or is expected to last longer than three months. For the purpose of this study, MLTCs are defined as living with two of more diagnosed chronic conditions.
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