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Building confidence in self care

NHS England’s National Lead for Self-Care with the New Care Models team looks at the marked effect self care can have on the NHS:

This is an important time to restate that supporting self care is not only the right thing to do, but it is a fundamental step to achieving the NHS’s triple aims of better care, better health and better value.

Self care, for me, is taking time out each week to run – this helps me ‘reset’ and look after my mental health. Since my last blog I’ve completed my fifth park run and a 10K!

More generally, it is the action that we each take to stay well and to manage long-term conditions.

We know that people who have the knowledge, skills and confidence to self care or who are more ‘activated’, have healthier lives, better outcomes and a lower impact on services.

Interim findings from a Health Foundation study, involving 10,427 patients from 34 general practices, found that a 20-point increase in activation was associated with 9% fewer GP contacts, 21% fewer A&E attendances and 23% fewer emergency admissions.

However, four in 10 people with long-term conditions don’t feel they have the ability to manage their own health and care. It’s crystal clear that we need to do more to support people to self care  by systematically implementing ‘what works’.

That’s exactly the approach we have been taking together with 15 vanguards around the country. By next April, we will have built the confidence and skills of 25,000 people to manage their conditions, through the delivery of tailored health coaching or self-management education. We are also supporting more people to stay well by improving access to community based support, such as walking clubs, which in the jargon we call ‘social prescribing’.

Importantly, we are laying the foundations to escalate the spread of support for self care from vanguards to Sustainability and Transformation Partnerships and Accountable Care Systems.

In West Yorkshire and Harrogate, the lead Chief Executive for the STP, Rob Webster says they are making supported self care part of their future vision for services, learning from vanguards and significant innovation in their community.

With a population of 2.6 million, they know the majority of their work and spending is linked to people with long-term conditions. They are committed to changing the relationship with them into a partnership – one that has a coordinated approach, with access to services when needed, so people feel supported to self care and self manage.

The STP recognises people with long-term mental and physical conditions look after themselves most of the time. By working together, they know they can make this simpler for people, more effective and more efficient too.

In Dudley, one in three people live with a long-term condition. The Dudley vanguard has introduced a new outcomes-for-health framework focused on mutual care planning.

More time is given to having conversations about what is important to the person, and setting personal health goals allows people to discuss what matters to them, not just what is the matter with them.

Peer support and the power of strong, connected communities are also key and they are continually working with partners, particularly the voluntary sector, to empower more people and communities to support each other – one example being the granting of small sums of money to help groups to establish.

Chief Executive, Paul Maubach, believes there is so much we can do as a system to create the right environment for self-care to flourish, for healthcare workers to have the time to care, to do the right thing and to support people and communities to thrive. Dudley vanguard is helping this to become a reality for its community.

Over at the Fylde Coast vanguard, Dr Amanda Doyle, NHS Blackpool’s Chief Clinical Officer sees many patients whose conditions could have been avoided if they had better knowledge of how to look after themselves or the confidence to self care.

She says it is important people understand their choices have an impact on the wider healthcare system and in Blackpool, Fylde and Wyre they are working on a self care strategy to help educate people and assess barriers that may be stopping people from doing more for themselves – not just on ways to treat minor ailments but how to stay fit and healthy.

Part of the answer is in understanding the range of support available in the community to help people to stay well before their health deteriorates.

Support for self-care has operated at the margins of care for far too long. So it’s great to see how system leaders are now bringing this in to the mainstream.

Pritti Mehta

Pritti Mehta is NHS England’s National Lead for Self-Care, New Care Models and is passionate about people-powered health and wellbeing.

She joined the New Care Models team at NHS England in 2016, where she is currently leading intensive work with 15 new care models to support the implementation and spread of self-care.

Pritti has a background in the voluntary sector and holds a Ph.D. in Developmental Genetics.

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