Variations in social care need reporting amongst GP practices in England: a retrospective cohort study in people with multimorbidity

Abstract

Background: multimorbidity, the presence of multiple chronic health conditions, presents significant challenges in both health and social care settings. Addressing social care needs, such as assistance with daily activities and support for managing finances, is crucial in care management patients with multimorbidity. However, variability in the documentation and reporting of these needs remains poorly understood. This study aimed to quantify the variations in social care need (SCN) reporting across GP practices in England.

Methods: we conducted a population-based study using electronic health records from a national sample of 873,092 individuals with multimorbidity. Inclusion and exclusion criteria were applied to determine the final cohort, with demographic and clinical data extracted. We analysed SCN reporting rates at the practice level, using interquartile ranges (IQRs) and intra-class coefficients (ICCs) to assess variability. Factors influencing SCN reporting were examined, including long-term conditions, demographic variables, and socio-economic deprivation.

Results: significant variability was observed in SCN reporting across GP practices. Outcomes related to mobility and residential needs showed the greatest differences in reporting rates. Moderate correlations were observed between certain SCN categories, such as mobility and activities of daily living, as well as disability and financial needs. Patients with long-term conditions, such as dementia and multiple sclerosis, were more likely to have their SCNs reported, while other multimorbidity conditions showed lower reporting rates. Demographic factors, including gender and socio-economic deprivation, were associated with higher reporting rates, particularly for females and patients in more deprived areas.

Conclusions: this study highlights the significant variability in the documentation of social care needs across healthcare practices, using electronic health records in a large population-based sample. The findings emphasise the need for standardised reporting practices to ensure comprehensive care for individuals with multimorbidity, particularly those from more deprived socio-economic backgrounds and with complex care needs. Improved reporting could enhance care coordination and reduce health inequalities.

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