A National Health Service in ‘Serious Trouble’: What do multiple long-term conditions tell us about deterioration in health among people accessing hospital care in the North East of England? – An analysis of electronic health records

Summary Objectives To estimate the prevalence of multiple long-term conditions (MLTC) among people accessing hospital care in North East England, and to assess associations with age, sex, ethnicity and neighbourhood deprivation. Design Analysis of electronic health records. Setting Secondary care. Participants All adults, 18 years and above, with ≥ 1 admission to Newcastle upon Tyne Hospitals NHS Foundation Trust (NuTH) between July 2018 and June 2019 (N = 88,117, 51% women) or between July 2021 and June 2022 (N = 83,036, 51% women). Main outcome measures MLTC; ≥2 long-term conditions. Results Between July 2018 and June 2019, overall prevalence of MLTC was 49.6%, and between July 2021 and June 2022 it was 61.0%. Older age and living in a more deprived neighbourhood were consistently associated with increased risk of MLTC, whereby people living in the most deprived neighbourhoods had a prevalence of MLTC equivalent to people from the least deprived neighbourhoods a decade older. Associations between neighbourhood deprivation and increased MLTC risk were stronger in younger adults; relative risk of MLTC was 1.74 (95% confidence interval: 1.49–2.02) when comparing people aged 30–39 living in the most and least deprived neighbourhoods. Conclusions Among adults accessing inpatient hospital care in North East England, the prevalence of MLTC is high in all age groups, has increased since the COVID-19 pandemic and has a greater impact on younger adults from more deprived neighbourhoods. This highlights the sheer scale of the challenge that MLTC present in hospitals and the value of harnessing information at a local level as we look to redesign hospital care fit for the future.