Supporting self care

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Supporting self care

• A training package for health and social care
  professionals

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Objectives of the training

• Overall objective
• To give guidance to PCT/practice/other care
  agency teams on how to establish a culture of
  self care or improve the promotion of self care
  by patients
• Session 1
• To agree the vision for promoting self care
  across the PCT/practice/care agency
• To agree how the self care strategy will be
  evolved and create an action plan for taking it
  forward
• To identify and agree priorities and target
  groups for promoting self care in the
  PCT/practice/care agency

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Supporting self care
A training package for health and social care
professionals
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Contents
An overview of self care support and self care

• What are self care and
• self care support?
• What is the policy context?
• What is the impact of self care support?

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What is self care?
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What do we mean by self care?1

• Self care is a part of daily living
• It is the care taken by individuals towards their
  own health and wellbeing
• It includes the care extended to their children,
  family, friends and others in neighbourhoods and
  local communities
• Most care in life is self care

1. Department of Health (2005). Self Care A
Real Choice Self Care Support A Practical
Option. London Department of Health.
7
Self care includes...1

• maintaining good physical and mental health
• meeting both social and psychological needs
• preventing illness or accidents
• caring for minor ailments and long-term
  conditions
• maintaining health and wellbeing after an acute
  illness or discharge from hospital

1. Department of Health (2005). Self Care A
Real Choice Self Care Support A Practical
Option. London Department of Health.
8
What do we mean by self care support?

• Health and social care support for self care
  involves increasing the capacity and confidence
  of the individual to self care, and building
  social capital in the community by such means as
  providing
• appropriate and accessible information in
  multi-media and multi-lingual format on how to
  take care of minor, acute and long-term
  conditions, and on what is a healthy lifestyle,
  eg physical activity, healthy eating
• health education programmes, eg adult health
  skills and health literacy programmes
• self care skills training, eg through the Expert
  Patients Programme
• first-aid training in schools for children

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What do we mean by self care support? (cont)

• self diagnostic tools, self monitoring devices
  and self care equipment and technologies
• individualised care plans
• self care support networks of people with
  experience and memory of healthy living, and of
  caring for a minor, acute or long-term condition
• support in the formation and implementation of
  relevant local and national government policies
• education of the public and practitioners to
  change their attitudes and behaviours towards
  self care
• training of practitioners in when and how to
  support self care
• work to develop partnerships between
  professionals and the public to enhance shared
  care

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The healthcare pyramid1
1. Department of Health (2005). Self Care A
Real Choice Self Care Support A Practical
Option. London Department of Health.
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The self care continuum
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What is the policy context?
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Supporting self care in context

• Several NHS policies and government papers have
  been published highlighting self care as a key
  priority

Supporting People with Long Term Conditions
Wanless Reports
GMS Contract
National Service Frameworks
Choosing Health
The NHS Improvement Plan
Self Care A Real Choice
Supporting People with Long Term
Conditions toSelf Care
Our health, our care, our say
Better Information, BetterChoices, Better Health
The Expert Patient
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Wanless Reports

• The NHS must evolve from1
• dealing with acute problems to promoting self
  care
• intervention at a population level (eg health
  promotion) to targeting behaviour on an
  individual level(including self care)
• Individuals are ultimately responsiblefor their
  own health and need to besupported to make
  better decisions1
• One of the key areas highlighted to offer the
  greatest potential was more self care by patients

1. Wanless D (2004). Securing Good Health for the
Whole Population Final Report. London HM
Treasury.
15
National Service Frameworks (NSFs)

• All of the NSFs emphasise the importance of self
  care1, eg
• Diabetes
• Supporting self care is a crucial aspect of any
  high-quality diabetes service2
• Long-term conditions
• Supporting self care can help transformservices
  for people with long-term neurological
  conditions3

1. Department of Health (2002). Chronic Disease
Management and Self-care. National Service
Frameworks A Practical Guide to Implementation
in Primary Care. London Department of Health. 2.
Department of Health (2005). Improving Diabetes
Services The NSF Two Years On. London
Department of Health. 3. Department of Health
(2005). National Service Framework for Long-term
Conditions. London Department of Health.
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The New General Medical Services (GMS) Contract1

• The new GMS contract enables primary care
  professionals to moderate their workload
  according to the income to which they aspire
• A clear strategy to use clinicians time
  effectively whilst improving theavailability of
  services for patientsis essential
• An integrated multi-disciplinary group the
  Working in Partnership Programme has been
  developed to maximise the effective use of
  services

1. BMAs General Practitioners Committee and the
NHS Confederation (2003). Investing in General
Practice The New General Medical Services
Contract. London British Medical Association and
the NHS Confederation.
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The NHS Improvement Plan1

• Public health will be given a greater emphasis to
  help prevent illnesses not just to treat them
• The NHS will develop into a health service rather
  than one that focuses primarily on sickness
• There will be more support for people to choose
  healthier lives

Self care is one of the key pillars of The NHS
Improvement Plan2
1. Department of Health (2004). The NHS
Improvement Plan Putting People at the Heart of
Public Services. Norwich Stationery Office. 2.
Department of Health (2005). Supporting People
with Long Term Conditions An NHS and Social
Care Model to Support Local Innovation and
Integration. London Department of Health.
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Supporting People with Long Term Conditions1

• For people with long-term conditions, self care
  has become increasingly important in improving
  wellbeing and quality of life, and maintaining
  independence

Supporting self care
Tools and devices
1. Department of Health (2005). Supporting People
with Long Term Conditions An NHS and Social
Care Model to Support Local Innovation and
Integration. London Department of Health.
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The Expert Patient

• The Expert Patients Programme is based on
• developing the confidence and motivation of
  patients to use their own skills and knowledge to
  take effective control of their lives1
• The Expert Patients Programme has produced a
  resource to help people and organisations
  develop and run self management programmes
• Stepping Stones to Success2

1. Department of Health (2001). The Expert
Patient A New Approach to Chronic Disease
Management for the 21st Century. London
Department of Health.. 2. Expert Patients
Programme (2005). Stepping Stones to Success An
Implementation, Training and Support Framework
for Lay Led Self-management Programmes. London
Department of Health.
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Self Care A Real Choice1

• Self care advice empowers people to treat
  themselves appropriately and avoid unnecessary
  medicine intake
• Minor illnesses account for 75 of AE visits
  around 15 of these
• illnesses have the potential to be
• taken care of by people themselves

1. Department of Health (2005). Self Care A
Real Choice Self Care Support A Practical
Option. London Department of Health.
21
Choosing Health1

• The NHS will increasingly becomea health
  improvement and preventionservice, supporting
  individuals tomake healthy, informed choices
• Choosing Health aims to
• inform and encourage people as individuals
• help shape the commercial andcultural
  environment we live in
• so that it is easier to choose a healthy
  lifestyle

1. Department of Health (2004). Choosing Health
Making Healthy Choices Easier. Norwich
Stationery Office.
22
Better Information, Better Choices, Better
Health1

• This strategy aims to specifically
• empower people to get the right information at
  the right time
• help people to confidently participate in
  healthcare decisions

This strategy will ultimately encourage greater
self care
1. Department of Health (2004). Better
Information, Better Choices, Better Health
Putting Information at the Centre of Health.
London Department of Health.
23
Our health, our care, our say a new direction
for community services1

• The White Paper is an important new stage in
  building a world-class health and social care
  system
• It builds on the foundations laid over the last 8
  years to
• reform and improve community services
• create health and social care services that focus
  on prevention and promote health and wellbeing
• deliver care in a more local setting
• deliver services that are flexible, integrated
  and responsive to peoples needs and wishes

1. Department of Health (2006). Our health, our
care, our say a new direction for community
services London Department of Health.
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Supporting People with Long Term Conditions
toSelf Care1

• A self care guide to support the White Paper,
  
• Our health, our care, our say
• Developed to help local organisations set up
• local strategies to deliver self care
  support for
• people with long-term conditions
• Delivering effective self care support also
• needs greater cooperation between
• organisations
• PCTs, GPs, local authorities and others
• need to work together wit the community,
• voluntary and private sectors to provide
• local solutions to embed supported self
• care into service delivery as a practical
  option

1. Department of Health (2006). Supporting People
with Long Term Conditions toSelf Care. London
Department of Health.
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What is the impact of self care support?
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The impact on patients1

• Better symptom management, such as a reduction in
  pain, anxiety, depression and tiredness
• Improved feeling of wellbeing
• Increase in life expectancy
• Improvement in quality of life with greater
  independence

1. Department of Health (2005). Self Care A
Real Choice Self Care Support A Practical
Option. London Department of Health.
27
The impact on general practice1

• Significant reductions in the number of
• hospitalisations
• visits to GPs
• AE visits1
• Outpatient visits can reduce by 172
• Medicines intake is regulated or reduced3

1. Lorig K et al. Med Care 19852310441054. 2.
Choy DK et al. Clin Exp Allergy 1999298490. 3.
Charlton I et al. BMJ 199030113551359.
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Self care support and self care1
1. Department of Health (2005). Self Care A
Real Choice Self Care Support A Practical
Option. London Department of Health.
29
Self care support and self care1
1. Department of Health (2005). Self Care A
Real Choice Self Care Support A Practical
Option. London Department of Health.
30
Self care support and self care1
1. Department of Health (2005). Self Care A
Real Choice Self Care Support A Practical
Option. London Department of Health.
31
The self care vision1

• Individuals and carers have self care as a real
  choice

• Choice includes a range of self care options that
  are available, accessible and convenient

• The right self care support is provided for that
  choice

1. Department of Health (2005). Self Care A
Real Choice Self Care Support A Practical
Option. London Department of Health.
32
About WiPP

• NHS organisation
• Established under the new GMS contract (paras.
  6.46 6.48)
• Their remit is to
• create capacity in primary care through improved
  workload management
• capture existing good practice
• commission new work

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WiPP objectives

• Identify and analyse workload issues
• Scope, evaluate and encourage the spread of
  existing good practice
• Identify gaps in current practice and commission
  new schemes
• Integrate into the wider agenda for long-term
  sustainability