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Background The increasing prevalence of multiple long-term conditions (MLTC) – the coexistence of two or more long-term health conditions – has been described as a significant public health challenge. Inpatient hospital services, configured to treat acute single conditions, are poorly equipped to provide care for this population and evidence suggests that hospital care may disadvantage people with MLTC. Studies indicate that people with MLTC experience worse health outcomes and report lower levels of satisfaction with hospital care than people with single conditions. Improving awareness of the lived experience of inpatient hospital care for people with MLTC makes an important contribution to understanding how hospital services might better meet the needs of this population.Methods Qualitative semi-structured one-to-one interviews were conducted with a diverse sample of people with MLTC who had received inpatient care in NHS hospitals in the last 6 months. Forty-four participants (23 women and 21 men) were recruited from the North East and North West of England and Yorkshire. Data were analysed inductively using thematic analysis.Results The study participants, aged 34 to 87 years, reported living with between 2 and 11 long-term conditions. Both positive and negative experiences were reported, shaped by patients’ expectations of hospital care. Three key themes with sub-themes were constructed during the analysis: internalising narratives of NHS hospital care, perceptions of alignment between clinician and patient knowledge, and organisational constraints to holistic care.Conclusion These findings have important implications for the transformation of hospital services, highlighting key factors that will need to be addressed to improve the care experiences of people living with MLTC and ensure the NHS is fit for the future.