Download Self-care and self-management

Self-care and self-management
Below is a short précis of the main policy, research and guidance papers relating to
self care and self management alongside a link to the actual documents themselves
for ease of reference.
Supporting self-management; A guide to enabling behaviour change for health and
wellbeing using person- and community-centred approaches (Realising the Value;
Sept 2016)
This guide outlines how the science of behaviour can help people to self-manage
their health and wellbeing. The guide is written for people who support those living
with long-term conditions, or who help people avoid these conditions using personand community-centred approaches.
http://www.nesta.org.uk/publications/supporting-self-management-guide-enablingbehaviour-change-health-and-wellbeing-using-person-and-community-centredapproaches
At the heart of health; Realising the value of people and communities (The Health
Foundation/NESTA; March 2016) Explores the value of people and communities at
the heart of health, in support of the NHS Five Year Forward View vision to develop a
new relationship with people and communities. The report finds that person- and
community-centred approaches for health and wellbeing have significant potential
to improve outcomes for individuals, support the development of strong and
resilient communities and, over time, help reduce demand on formal health and
social care services. There is evidence from both research and practice to
demonstrate the benefits of person- and community-centred approaches.
http://www.nesta.org.uk/publications/heart-health-realising-value-people-andcommunities
A practical guide to self-management support; Key components for successful
implementation (The Health Foundation, Dec 2015) Health policy, and increasing
evidence of positive outcomes, highlight the benefit of supporting people to manage
their own health as effectively as possible. These benefits can be felt by people with
long-term health conditions, health professionals, providers (both within and beyond
the NHS) and commissioners. Together with good quality clinical care, selfmanagement support ensures that people receive the full range of support they
need to manage the physical, emotional and social impact of their long-term health
conditions at different stages and ages during their lives.
http://www.health.org.uk/publication/practical-guide-self-management-support
A rapid synthesis of the evidence on interventions supporting self-management for
people with long-term conditions: PRISMS – Practical systematic Review of SelfManagement Support for long-term conditions (Health Services and Delivery
Research; Volume 2 Issue 53, December 2014) concludes that supporting good selfmanagement is inseparable from the high-quality care all people with Long Term
Conditions (LTCs) should receive. Supporting self-management is not a substitute for
care from doctors and nurses but a hallmark of good care. Providers of services for
people with LTCs should consider how they can actively support self-management.
Effective self-management support usually has many components, should be
flexible, tailored to the individual and their LTC, and be underpinned by good
collaboration between the patient and a trusted health-care professional, all within a
health-care organisation that actively promotes self-management.
http://www.journalslibrary.nihr.ac.uk/hsdr/volume-2/issue-53#abstract
Supporting people to manage their health; an introduction to patient activation
(The Kings Fund, May 2014) Recognises that patients with low activation levels are
more likely to attend A&E departments, be hospitalised or re-admitted after
discharge, leading to higher health care costs. Intervening to increase activation can
improve a patient’s engagement and health outcomes and is an important factor in
helping patients to manage their health. In the management of long-term
conditions, higher activation scores are positively correlated with adherence to
treatment and condition monitoring. Patient activation is not only linked to clinical
and economic outcomes, but also to the patient’s experiences.
http://www.kingsfund.org.uk/publications/supporting-people-manage-their-health
Supporting self-management; Summarising evidence from systematic reviews
(National Voices, March 2014) A compilation of information from 228 systematic
reviews which found that the top things you can do to support self-management are:
 providing self-management education for people with specific conditions
which is integrated into routine healthcare
 generic self-management education courses co-led by peers / laypeople
 interactive online self-management programmes
 telephone support and telehealth initiatives
 self-monitoring of medication and symptoms
http://www.nationalvoices.org.uk/node/1337
Delivering better services for people with long term conditions; building the house
of care (The Kings Fund, October 2013) The management of care for people with
long-term conditions should be proactive, holistic, preventive and patient-centred.
This report describes a co-ordinated service delivery model – the ‘house of care’ –
that incorporates learning from a number of sites in England that have been working
to achieve these goals. The house of care model differs from others in two important
ways: it encompasses all people with long-term conditions, not just those with a
single disease or in high-risk groups; and it assumes an active role for patients, with
collaborative personalised care planning at its heart. Implementing the model
requires health care professionals to abandon traditional ways of thinking and
behaving, where they see themselves as the primary decision-makers, and instead
shifting to a partnership model in which patients play an active part in determining
their own care and support needs. An important feature of the approach is the link
between care planning for individuals and commissioning for local populations; it
aims to make best use of local authority services (including social care and public
health).
http://www.kingsfund.org.uk/publications/delivering-better-services-people-longterm-conditions
Sustaining and spreading self-management support; Lessons from Co-Creating
Health phase 2 (The Health Foundation, September 2013) The Co-creating Health
programme involved the piloting of an approach to implementing self-management
support that comprised:
 self-management training for people with long-term conditions
 training in self-management support skills for clinicians
 a service improvement programme to put systems and processes in place to
support patients and clinicians in their self-management activities
The findings of the evaluation of phase 2 of Co-creating Health show that three
broad mechanisms were important in sustaining the Co-creating Health model of
self-management support: (1) co-production; (2) changing practice amongst
clinicians; (3) the patient journey.
http://www.health.org.uk/publication/sustaining-and-spreading-self-managementsupport
It is evident from strategic policy drivers and academic literature that public, patient
and carer participation, involvement and self-care are intrinsically linked to
improved health and well-being outcomes and a reduction in reliance on formal
health and care services.
Whilst statutory organisations are required to demonstrate involvement and
participation of their communities, it is also clear that there are wider benefits to
both an individual’s health and the wider community from this approach.