Supported self-management: the evidence base
Hear others’ stories about how implementing the Patient Activation Measure has made a real difference in people’s lives’:
- Blackpool Teaching Hospitals Foundation Trust
- West London CCG
- Working with a health and wellbeing support worker helped Victoria to better manage her condition. Now she’s more confident, is making friends and dreaming again
- A Prehabilitation Project Manager considers how Macmillan is incorporating personalised care to form a wealthier conversation with people post cancer diagnosis, empowering them to become involved in their care plan and enabling more tailored and individual support
- A Chronic Obstructive Pulmonary Disease (COPD) Specialist Nurse at Solent NHS Trust led on the refinement of personal care planning based on Patient Activation Measure (PAM) scores within respiratory services. The project has led to improved engagement, outcomes and experiences for those using respiratory services at the Trust
- Practitioners in primary care and social prescribing talk about the value of using the Patient Activation Measure to assess patients levels of knowledge, skills and confidence, enabling them to provide the support that is right for the patient and see the impact of their work is having with their patients.
- Stephen tells us how health coaching supported him to improve his skills, knowledge and confidence to manage his conditions from a PAM level 2 to a level 4, improve his health and have a more positive outlook on life.
NHS England worked with partners through an Action Learning Set to understand how patient activation can increase and encourage personalised care in the NHS.
Its evaluation focuses on practical lessons and points to consider for others interested in using PAM in their local areas, the final report is available on the FutureNHS platform (please note this platform requires users to log in). Site summaries from the learning set are available:
- Somerset CCG
- Tower Hamlets CCG
- Horsham and Mid Sussex CCG and Crawley CCG
- Islington CCG
- Sheffield CCG
- UK Renal Registry
Research published by the Health Foundation shows that supporting patients to manage their health conditions can reduce avoidable use of health services.
Studies in Islington CCG have found that patient activation is associated with fewer visits to both general practice and emergency departments and self-management capability in patients with long-term conditions is associated with reduced healthcare utilisation.
Helping patients help themselves: A systematic review of self-management support strategies in primary health care practice provides primary care professionals with evidence-based strategies and structure to deliver supported self-management in practice.
The Realising the Value Programme set out to strengthen the case for a shift in the relationship between patients and communities, identify evidence-based approaches that engage people in their own health and care; and develop practical tools to support implementation across the NHS and local communities. These approaches include self-management education courses for people with specific conditions, peer-to-peer support and community based activities. The report and related documents can be found on the Nesta web pages.
The Coalition for Collaborative Care published a paper describing a pilot of a person-centred approach to how primary care can support people living with diabetes. The pilot was set up as first step towards how we can assess and segment people living with long-term conditions like diabetes, so that care can be tailored to their individual needs.
The NHS’s Transforming Participation in Chronic Kidney Disease programme was developed to support and empower people living with chronic kidney disease and their families to achieve the personal and clinical goals that are important to them, wherever they are in the pathway of care. This aimed to support patients, carers and clinicians to develop the skills, knowledge and confidence to work together towards the best possible clinical and person-centred outcomes.
In 2015 NHS England ran a survey, with the help of some Royal Colleges and other organisations, of over 1750 clinicians to understand their support for patient activation. The survey explores clinicians’ attitudes and beliefs, their self-reported behaviours and practices, and provides insight into their perceived barriers and support needs. The findings of this survey are available in the report: How much do clinicians support patient activation?
The ‘Peer Support: What is it and does it work?‘ report published by National Voices and Nesta provides evidence that peer support can help people feel more knowledgeable, confident and happy, and less isolated and alone.