This project was funded between May 2016 and October 2018.

  • Led by King's College Hospital and working with Guy’s and St Thomas’ NHS Foundation Trust, and South London and Maudsley NHS Foundation Trust (the Trusts that form King’s Health Partners’ Academic Health Science Centre).
  • The 3 Dimensions for Long-term Conditions (3DLC) programme was introduced across community and secondary care in Lambeth and Southwark.
  • It involved scaling up of a successful diabetes programme to other long-term conditions, with the aim of improving outcomes, mental health, quality of life, social functioning and service utilisation.

Common mental health disorders are more prevalent in people with long-term conditions, such as diabetes, cardiovascular disease (CVD) and chronic obstructive pulmonary disease (COPD). These conditions require significant self-management but there is no integrated psychological or social care for these patients.

Treating psychiatric co-morbidities has been shown to reduce morbidity and mortality in people with long-term conditions. The 3 Dimensions of Care for Diabetes (3DFD) programme is an initiative that has effectively integrated psychological and social support within diabetes services. 3DFD has demonstrated clinically significant improvements in glycaemic control, depression, anxiety, social outcomes and subsequently, significant financial savings. 

3 Dimensions for Long-term Conditions (3DLC) has scaled up 3DFD by integrating medical, psychological and social care for people in Lambeth and Southwark who have other long-term conditions (cardiac failure and COPD) and a mental health and/or social problem, where their co-morbidity is impacting on self-management.

The project involved adapting the current physical health model across primary, community and secondary care, and supporting an integrated care delivery system that encompasses social and psychological support.

The project team worked with staff and patients to develop care pathways that integrate a biopsychosocial model for heart failure, resistant hypertension and COPD. There is also a separate diabetes arm within the community mental health team. 

So far, over 2,000 patients (46% with COPD, 31% with hypertension and 28% with heart failure) have been screened for anxiety and depression, with 752 referrals received and 504 assessments offered.

The service is now well established within the long-term conditions clinical teams. There has also been interest from other services in adopting the 3DLC stepped care model and approach.

Contact details

  • Professor Khalida Ismail, Professor of Psychiatry and Diabetes, King’s College London, khalida.2.ismail@kcl.ac.uk
  • Dr Sean Cross, Consultant Liaison Psychiatrist, Department of Psychological Medicine, King’s College Hospital, sean.cross@slam.nhs.uk
  • Dr Carol Gayle, Consultant Diabetologist, Kings College Hospital, carol.gayle@nhs.net

About this programme

Programme

Scaling Up Improvement

Programme

This programme offers £500,000 funding to supports teams to take successful interventions or...

You might also like...

Event

Webinar: Can politicians 'get social care done'?

Event

Understanding the political dynamics behind finally achieving substantive reform of the social care...

Press release

MPs highlight major gaps in the government’s reform agenda for the NHS and social care

Press release

Health Foundation response to the report by the Health and Social Care Select Committee on the...

Kjell-bubble-diagramArtboard 101 copy

Get social

How can we foster a conducive environment for adopting and sustaining innovation and technology in the NHS? Our la… https://t.co/0FWvrwRFfJ

Follow us on Twitter
Kjell-bubble-diagramArtboard 101

Work with us

We look for talented and passionate individuals as everyone at the Health Foundation has an important role to play.

View current vacancies
Artboard 101 copy 2

The Q community

Q is an initiative connecting people with improvement expertise across the UK.

Find out more