The University of Strathclyde has partnered with NHS Lanarkshire and NHS Highland on a transformative project aimed at improving care for patients living with multiple long-term health conditions.
The SEISMIC SHIFT project is taking a ‘whole system, whole person, whole life’ approach, moving away from traditional disease-specific treatment models and focusing instead on symptom-led care.
The project seeks to relieve the pressure placed on the NHS due to the rising number of patients with multiple chronic conditions by creating a care model that integrates clinical specialisms and prioritises the needs of patients, carers, and healthcare professionals.
This systems-based redesign shifts the focus from disease specialisms to clusters of symptoms, reflecting patients' lived experiences and aiming to provide more comprehensive and personalised care.
New approaches
In its initial phase, SEISMIC SHIFT, funded by the National Institute for Health and Care Research and the Engineering and Physical Sciences Research Council, brought together a team of design, engineering, and clinical researchers to gather insights from patients, carers, and healthcare professionals.
Working closely with NHS Lanarkshire and NHS Highland, the project has already tested new approaches to the prevention, diagnosis, and treatment of breathlessness, a complex symptom common among patients with multiple health conditions.
NHS Lanarkshire has completed a three-month test of a multi-disciplinary team (MDT) following a symptom-led approach, which brought together Cardiology and Respiratory specialists to review cases of breathlessness. Early results show that such a symptom-focused pathway can improve patient outcomes, with several patients initially assigned to one speciality being reallocated to another based on MDT review findings.
NHS Highland faces unique challenges related to its rural geography and diverse patient demographics. Through workshops with patients, carers, and staff, the project has created a set of service user ‘personas’ that illustrate varied health journeys, serving as the foundation for a portfolio of tailored interventions.
Proposals range from education and empowerment schemes to new appointment models, with the broader impact of each carefully considered from both a healthcare system and service user perspective. Feedback from staff and service users will shape the final form of these interventions and the next phase of the project.
Transformative change
Professor Anja Maier, Principal Investigator and Head of Design, Manufacturing and Engineering Management at the University of Strathclyde, said: “The NHS is currently organised around disease-specific specialisms, with cardiologists treating heart disease and respiratory specialists treating lung disease.
“However, this structure does not reflect the experiences of the growing population living with multiple long-term conditions who wish to be treated as whole persons.
“SEISMIC SHIFT proposes a bold new approach, reversing the disease-centred model to provide care that is focused on the full range of patient symptoms, supporting prevention, diagnosis, and long-term management.
An NHS that treats individuals in an integrated manner is the transformative change at the core of SEISMIC SHIFT.
The project is now planning for a multi-year phase, expanding its focus to address additional symptom clusters, including pain, frailty, anxiety, depression, and fatigue. SEISMIC SHIFT will continue to work with NHS partners, using socio-technical systems design and knowledge transfer to deliver long-term impact and sustainable change.