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Nurses delivering person-centred multiple long-term condition reviews in primary care: a secondary analysis of qualitative data

Nurses delivering person-centred multiple long-term condition reviews in primary care: a secondary analysis of qualitative data
Nurses delivering person-centred multiple long-term condition reviews in primary care: a secondary analysis of qualitative data
Background: general practice nurses in England often manage long-term conditions, with more people now living with multiple conditions (MLTC). Evidence on the effectiveness and delivery of person-centred care for MLTC is limited, and the nurse’s role - including necessary training - remains underexplored.

Aim: to identify and characterise general practice nurses’ experiences of undertaking person-centred multiple long-term condition reviews in England.

Design and setting : secondary analysis of qualitative data gathered from general practice staff in England.

Methods: two-part review consultations for people with three or more long-term conditions (rather than separate single-condition reviews as per usual care) in sixteen English general practices, part of a larger implementation project (PP4M). Empirical qualitative data (healthcare staff interviews and researcher fieldnotes) and theoretical approaches (chronic care model, normalisation process theory) analysed abductively.

Results: two overarching themes identified:

(1) Healthcare professionals’ understanding of MLTC reviews’ purpose

(2) Challenges and opportunities for nurses delivering MLTC reviews.

Some nurses utilised reviews as data-gathering exercises, facilitating collection of nationally set, quality-driven, financial incentives linked to single-conditions. Other nurses used reviews as opportunities for meaningful discussion of complex
problems, leading to action. MLTC reviews allowed nurses a new way of thinking. Some found this empowering, others found it challenging.

Conclusion: general practice nurses are central to MLTC care. They value organisational support for training in person-centred MLTC management, but it remains unclear how best to achieve necessary training. Further research is needed on skills and training required for all healthcare professionals caring for people with MLTC.

Key words: nursing, general practice, annual review; multimorbidity; organisation of care
0960-1643
Lippiett, Kate Alice
35184a9f-cf3c-49cc-ae6b-7b92f6ead7ee
Turner, Andrew
deb606b8-c47e-40ee-9007-3eef16721bab
Coope, Caroline
971a9b96-d0ef-4e0b-a34c-9f9d954096ec
Mann, Cindy
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Moult, Alice
c9c2fc50-3e01-4a71-9f49-5f6416439392
Baker, Dereth
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Chilcott, Simon
e0ed5212-2f6b-4f7e-8b18-d84ca0ca66d6
Jinks, Clare
26785dc0-7282-4165-8ce0-42a5a135df78
Dziedzic, Krysia
b2fe3d66-6300-4bb8-8a9f-e895fa102603
Finney, Andrew
Salisbury, Chris
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Johnson, Rachel
04d6fdc1-43e1-46c4-9b4f-99e25afaa87b
Portillo-Vega, Mari Carmen
f913b5c5-b949-48f2-b1d0-eb7505484d5c
Lippiett, Kate Alice
35184a9f-cf3c-49cc-ae6b-7b92f6ead7ee
Turner, Andrew
deb606b8-c47e-40ee-9007-3eef16721bab
Coope, Caroline
971a9b96-d0ef-4e0b-a34c-9f9d954096ec
Mann, Cindy
d269414f-2722-4484-bf71-25522becabb1
Moult, Alice
c9c2fc50-3e01-4a71-9f49-5f6416439392
Baker, Dereth
fa4ecb91-5785-40e4-a3f6-62e16aab967a
Chilcott, Simon
e0ed5212-2f6b-4f7e-8b18-d84ca0ca66d6
Jinks, Clare
26785dc0-7282-4165-8ce0-42a5a135df78
Dziedzic, Krysia
b2fe3d66-6300-4bb8-8a9f-e895fa102603
Finney, Andrew
Salisbury, Chris
50e9a5a0-c074-4af8-9b1b-e1e8408aae3c
Johnson, Rachel
04d6fdc1-43e1-46c4-9b4f-99e25afaa87b
Portillo-Vega, Mari Carmen
f913b5c5-b949-48f2-b1d0-eb7505484d5c

Lippiett, Kate Alice, Turner, Andrew, Coope, Caroline, Mann, Cindy, Moult, Alice, Baker, Dereth, Chilcott, Simon, Jinks, Clare, Dziedzic, Krysia, Finney, Andrew, Salisbury, Chris, Johnson, Rachel and Portillo-Vega, Mari Carmen (2026) Nurses delivering person-centred multiple long-term condition reviews in primary care: a secondary analysis of qualitative data. BJGP. (doi:10.3399/BJGPO.2025.0184).

Record type: Article

Abstract

Background: general practice nurses in England often manage long-term conditions, with more people now living with multiple conditions (MLTC). Evidence on the effectiveness and delivery of person-centred care for MLTC is limited, and the nurse’s role - including necessary training - remains underexplored.

Aim: to identify and characterise general practice nurses’ experiences of undertaking person-centred multiple long-term condition reviews in England.

Design and setting : secondary analysis of qualitative data gathered from general practice staff in England.

Methods: two-part review consultations for people with three or more long-term conditions (rather than separate single-condition reviews as per usual care) in sixteen English general practices, part of a larger implementation project (PP4M). Empirical qualitative data (healthcare staff interviews and researcher fieldnotes) and theoretical approaches (chronic care model, normalisation process theory) analysed abductively.

Results: two overarching themes identified:

(1) Healthcare professionals’ understanding of MLTC reviews’ purpose

(2) Challenges and opportunities for nurses delivering MLTC reviews.

Some nurses utilised reviews as data-gathering exercises, facilitating collection of nationally set, quality-driven, financial incentives linked to single-conditions. Other nurses used reviews as opportunities for meaningful discussion of complex
problems, leading to action. MLTC reviews allowed nurses a new way of thinking. Some found this empowering, others found it challenging.

Conclusion: general practice nurses are central to MLTC care. They value organisational support for training in person-centred MLTC management, but it remains unclear how best to achieve necessary training. Further research is needed on skills and training required for all healthcare professionals caring for people with MLTC.

Key words: nursing, general practice, annual review; multimorbidity; organisation of care

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More information

Accepted/In Press date: 23 January 2026
e-pub ahead of print date: 27 February 2026

Identifiers

Local EPrints ID: 510787
URI: http://eprints.soton.ac.uk/id/eprint/510787
ISSN: 0960-1643
PURE UUID: 5d3811d1-bda9-421d-9561-839ac609bd28
ORCID for Kate Alice Lippiett: ORCID iD orcid.org/0000-0003-2626-498X
ORCID for Mari Carmen Portillo-Vega: ORCID iD orcid.org/0000-0003-1583-6612

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Date deposited: 21 Apr 2026 17:02
Last modified: 22 Apr 2026 01:59

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Contributors

Author: Andrew Turner
Author: Caroline Coope
Author: Cindy Mann
Author: Alice Moult
Author: Dereth Baker
Author: Simon Chilcott
Author: Clare Jinks
Author: Krysia Dziedzic
Author: Andrew Finney
Author: Chris Salisbury
Author: Rachel Johnson

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