This document summarizes the outcomes of a self-management workshop. Key points include: engaging patients is important for self-management; providing diverse self-management resources embedded in clinical pathways makes it easier for all parties; professionals need skills to motivate self-management and refer to resources; patients and carers benefit from feeling empowered and knowing where to access help; and a pathway approach along with expanding skill sets can help address self-management of health issues holistically rather than just mental health aspects. The group discussed quick wins like a website with resources and embedding some into clinical pathways, as well as longer term goals like culture change across the healthcare system and not just calling it "self management".

1. OUTCOMES FROM THE JOINT
Self-management workshop
Focolare Centre
10th
June 2014

2. Initial thoughts
• Ways of engaging patients essential to get
them to engage
• Self management resources for acute
illnesses e.g. leaflets on where to go and
how to manage a sore throat are a quick
win
• Resources are diverse so embedding
them in pathways makes it easier for
clinicians, patients and carers

3. Good outcomes
• Professionals with skills and knowledge to
motivate and refer on
• Patients feeling they can manage
themselves and know where and how to
go
• People feel signposted
• Carers feel empowered
• People can deal with whole disease not
just mental health aspects

4. Some Principles
• Pathway approach
• Behaviourist as well as cognitive tools – psychology of
resilience
• Self-serve (net, leaflets etc) easy access essential
• Take away barriers to help (e.g. IAPT – empowering
people not assessing psychological morbidity)
• Health Psychology skills across health and social care
• Revisit how we commission holistically
• Revisit IAPT (outcomes, processes, pathways, skills of
IAPT providers) to deal with resilience aspects of long
term conditions not just mental health aspects
• Capacity and scope to respond to variety of needs and
challenges

5. The Big 4 Things
1. Engage patients in their own care and
management and make it easier (so use
3rd
sector, websites etc)
2. Pathways
3. Look wider than anxiety/depression and
into resilience
4. Widen skill sets of practitioners to deliver
motivation/mindset resilience as well as
having specialist places to go (IAPT?)

6. Some models.
1. Pathways – clinicians having enough
patient/professional interaction psychology to
motivate patients
2. Sessional health psycholgists in practices with
some skills in professionals?
3. One person in each team with ehnanced skills?
4. The Cambridge diabetes model – skilled
patients with professional support doing the
work (health education model)
5. The HIV model – newly diagnosed etc

7. Groupwork 1 - Feedback
• Signposting of resources
• Psychological and insightful marketing to people
you’d like to engage in self management to get
people on board
• Ownership across the system – continuity
between conversations on self management
across the system. Integration and planned
elements of personal health plans
• Every point the patient hits self management
gets picked up (all clinicians are responsible for
health and wellbeing of patient AS A WHOLE) -
ownership

8. Groupwork 1 – Feedback (2)
• Tendency for system as a whole to make
you feel completely powerless, which is
not good
• Evidence base being better shared to get
engagement – so why self management is
important, and what the impact of it can be
• Disseminating evidence AND impact
• ALL health professionals in system not
just GPs –anyone in a carer position

9. Groupwork 1 – Feedback (3)
• Engendering a general philosophy as people that the
first approach to any issue is what am I doing myself – is
there scope for schools work? (Cultural change. I am in
control)
• Find a way of supporting families (parenting skills to help
parents empower kids to be resilient)
• Professionals understanding that many will eventually
make the change but many havent necessarily had
much power, so small changes – need to believe it will
work – Positive psychology interventions with
professionals
• Takes time

10. Groupwork 1 – Feedback (4)
• Debating between a self management service
one could refer into (eg as bolster to IAPT to get
people motivated from step 1)
• A patient questionnaire for patients to consider
how activated they are?
• Setting some torchbearers running in some
conditions like cardiac rehab and different
patient groups to make it fashionable and
exciting – “market leaders”
• Culture and whole system change
• Signposting and resources being the norm

11. Groupwork 1 – Feedback (5)
• Ultimate aim is decrease in LTC
prevalence and complications and
increase in motivation and wellbeing
• Depression and hopelessness linked to
this which mitigates against people
wanting to do anything for themselves
– Meaning and purpose (if life is meaningless
why live till tomorrow?)
• Invest in culture change – staff and
patients across whole system

12. Groupwork 1 - Some quick wins
• Website to loads of different resources for
patients, carers and professionals – leaflets,
videos, sources etc
• Embed some specific things into pathways like
respiratory tools for respiratory pathways etc
• Training professionals in evidence and
behaviour change
• Employers – encourage employers to do healthy
things
• Community navigators as part of the discharge
team, self management as part of discharge

13. Next Steps….
• Co-production with users and carers and
public
– Into vol sector strategy and commissioning for
outcomes
• Localities and patient participation groups
in each ccg
– Enhccg planned programme board
– Hvccg to planned and primary and integration
• Hcc integration group
• Don’t call it self management

14. Better Care Fund
• Expand on the self management and prevention
line in the BCF paper, get it through everyone
and then back to HWBB
• A quick strategy
• DPH please
• Self management workstream
• Keeping the conversation very open
• What are the top 20 things we know about
already that are really cool that people are doing
• Activitists we can rope in
• Care homes doing better basics – HCPA needs

15. To remember
• Social isolation
• Prevention
• Schools
• (not in direct scope, but make links)

16. Some process points
• Jim McManus – paper and project plan, project lead
• Tim Anfilogogg - activists
• Raj and Linda– 20 things already doing
• Rachel – sense check
• Michelle – write up
• Jim –convene task group
• -2% most vulnerable patients – make this work relevant to it to get
buy in from practices – word in a way it supports that –
• Gerry and MarieAnne and Daniel as checkers of the plan for this
“handle” identify where this will be most useful for implementations.
Four top long term conditions and weight loss and stop smoking