On and on and on

NHS England’s Personalised Care Group Clinical Director gives his view on how a personalised self care approach makes self-management achievable and rewarding:

It’s Self Care Week this week but for those of us living with long term health conditions it’s self care week every week.

We have no option other than to live day to day with our health conditions and to manage them as best we can.

And some of us manage more confidently than others.

We know from work commissioned by the Health Foundation over a decade ago and from a similar study by academics in Manchester in 2016 that perhaps four people in 10 living with long term conditions don’t have the confidence, skills and knowledge to manage their health and wellbeing on a daily basis.

Furthermore, recent research by the Health Foundation also tells us that these people with low levels of confidence, skills and knowledge, which is sometimes described as low levels of ‘activation’- not a term that is universally admired, tend to visit their GP or use emergency services more frequently than those with higher levels of ‘activation’.

But the sad fact is that its absolutely not inevitable that four people in 10 living with long term conditions should struggle to manage their health and wellbeing on a daily basis.

There are pockets of the country where inspirational teams are working with their communities to change this statistic – and the individual lives behind the headline number. These teams are putting in place a more proactive approach through personalised care and support planning. They are providing health coaching to support people with low levels of confidence to recognise and develop their own sense of resourcefulness and they are ensuring people are connected with their communities through social prescribing in order to enhance their sense of wellbeing and give them confidence to engage with managing their health.

For instance, in Newcastle and Gateshead, nearly every primary care team is practising personalised care and support planning. They are finding that not only are they supporting people living with long term conditions to live well, the change in practice is more professionally rewarding so it’s having a discernible impact on the quality of life of the clinical team members.

Ollie Hart and his team in Sheffield tell me the same thing – though they are taking a slightly different approach to the Newcastle teams. In Ollie’s practice, they are purposefully focussing on people at lower levels of activation and providing them with health coaching and social prescribing. Again, they are finding that people at lower levels of confidence, knowledge and skills are becoming more confident and again, staff in the practice are finding work more rewarding.

Lastly, in Frome, the team there is focussing on connecting people with their communities and the same findings are emerging. Their data on the power of connecting people with their communities is so impressive it has recently been published in the British Journal of General Practice.

None of these brief snapshots do justice to the hard work and determination that has driven these changes in practice. And at their heart, though each may look slightly different, all of them share a common goal: to deliver personalised, proactive care planning for people living with long term conditions in order to provide them with coaching and/or community support so that they develop the confidence, skills and knowledge to live well with their conditions.

None of it is earth-shattering, none of it is high tech; all it has taken is a few determined individuals and teams to bring about a deep transformation in care that is changing people’s lives for the better.

Having been involved in the use of the patient activation measure (PAM) in this country since 2006, I along with a few close friends and colleagues, have been banging on and on and on about the transformation in care that the thoughtful use of the measure might bring about.

And it is truly wonderful to report the amazing work that is happening.

Work that ‘meets people where they are’ from a psychological perspective and then helps them to transform their lives.

Work that is supporting people to manage their health and wellbeing on a daily basis – to confidently self-manage not just this week, but every week.

Alf Collins

Professor Alf Collins is NHS England’s Clinical Director, Personalised Care Group.

He was a community consultant in pain management and in parallel worked for a decade with the Health Foundation. He has researched and published widely on self-management support, shared decision making, care planning, co-production, patient activation and patient engagement.

He has honorary fellowships from the Royal College of Physicians and the Royal College of General Practitioners and is a Visiting Professor at Coventry University.

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One comment

  1. Jo Trewartha says:

    Lovely sentiment pervades your writing here …that the power lies within people themselves to make positive changes … thank you ??❤️