A project to transform health and care services for people living with multiple long-term conditions (MLTCs) has secured a further five years of funding, taking total investment to more than £6 million.
The SEISMIC SHIFT programme – Systemic Health Innovation Future Transformation – is one of three that have received renewed support from the National Institute for Health and Care Research (NIHR) and the Engineering and Physical Sciences Research Council (EPSRC). Each programme is now entering a second phase following a £17.9 million UK wide funding boost for research into MLTCs.
Led by the University of Strathclyde in partnership with NHS Lanarkshire, NHS Highland, NHS 24, and an extensive network of collaborators across Scotland and the UK more widely, SEISMIC SHIFT brings together systems design and engineering researchers with clinicians, public health specialists and social care partners to rethink how care is organised for people with complex health needs.
Redesigning services
Rather than treating conditions in isolation, the programme focuses on redesigning services around clusters of symptoms, reflecting patients’ lived experience and supporting a shift from disease-based care to symptom focused, whole person support. The approach applies systems thinking and systems engineering to embed new ways of working directly into health and care settings.
The next phase will see the partnership working across diverse environments, from deprived urban communities to remote and rural regions, to co‑design and test innovations that can be scaled nationally.
Lead Investigator Professor Anja Maier, Distinguished Professor of Engineering Systems Design at Strathclyde, said: “This investment is a major milestone for SEISMIC SHIFT and allows us to accelerate ambitious work that enables a fundamental shift in how healthcare is experienced by people living with multiple long-term conditions.
By embedding systems expertise in health and care, we aim to redesign services around people’s real experiences while strengthening the NHS for the future.
In NHS Lanarkshire, where GP caseloads are among the highest in Scotland, the focus will be on identifying the value from improved coordination across primary, secondary and community care to reduce pressures across the whole system.
Fragmented pathways
Joint-Lead Applicant Professor Andrew Smith, Consultant Respiratory Physician at NHS Lanarkshire, said: “People living with multiple long-term conditions often navigate complex and fragmented pathways through the health system. SEISMIC SHIFT gives us an opportunity to rethink how care is organised and to deliver services that are more integrated, efficient and sustainable for both patients and staff.”
In NHS Highland, which covers the UK’s largest geographical health board area, the programme will explore new community based and remote models of care to address the challenges of an ageing population, workforce shortages and sustainability targets.
Working with NHS 24, a national platform for symptom-based triage, SEISMIC SHIFT will examine how patients with MLTCs can be navigated effectively to reduce avoidable demand on urgent and unscheduled care services and improve continuity of care.
The new funding builds on a successful development phase launched in 2023, during which the partnership tested new approaches to the prevention, diagnosis and treatment of breathlessness, a common and complex symptom among people with MLTCs.
Dr Beth Sage, Co‑Applicant, Consultant Respiratory Physician and Director of Research, Development and Innovation at NHS Highland, said: “In my day‑to‑day clinical work, patients don’t arrive with a diagnosis they come because a symptom is affecting their life.
Traditional NHS systems haven’t always reflected that reality. SEISMIC‑SHIFT gives us the opportunity to rethink how we deliver care around what matters most to patients, creating simpler, more responsive pathways from the very first presentation.
“It’s an ambitious and genuinely exciting programme, with the potential to improve care not just locally, but nationally, especially for people living in remote and rural communities.”
Faster routes
In NHS Lanarkshire, a three-month pilot of a symptom led multidisciplinary team brought together cardiology and respiratory specialists to review cases of breathlessness. Early findings indicate patient satisfaction with a pathway that delivers more appropriate referrals, reduces demand on specialty clinics, and enables faster routes to symptom treatment and management.
In NHS Highland, workshops with patients, carers and staff led to the development of service user personas illustrating different health journeys. These personas motivated a portfolio of tailored interventions, ranging from education and self-management support to new appointment models that are now being developed as part of the next phase of the programme.