Enid FeatherClinical Lead Self Care and Prevention

Self care and prevention through patient and staff activation

Aims of presentation

• National and local context• What is self care and prevention?• Models and Myths• The self care journey• Where are we now?• Question time?

National Context• NHS success at saving lives so people live longer• Many with a significant proportion of poor

health• More people with more than one long term

condition• Some conditions attributable to lifestyle choice• More people with caring responsibilities• Increased demands on health and social care

Bradford District and Craven Self Care and Prevention Programme

• Reports to the Integration and Change Board and up the Health and Wellbeing Board

• Bradford has delegated responsibility for public health in North Yorkshire

• Priorities are– Promoting health, wellbeing and independence for all– Preventing deterioration , delaying dependence and

supporting recovery for those with long term conditions

Airedale, Wharfedale and Craven, Clinical Commissioning Group

• Clinical Lead: Self Care and Prevention• Self Care and Prevention reports into the New

Models of Care Integrated Delivery Board• Self Care and Prevention initiatives increasing

since launch in November 2014• Maximise opportunities from Bradford and

Craven programme and work streams

What is self care?‘Self Care is a lifelong habit for patients and the public

dealing appropriately, effectively and safely with their own minor ailments

and long term conditions, taking preventative measures to stay fit,

and maintaining good physical and mental health and wellbeing.’

Ref Health Care Forum.

The Self Care Continuum

Prevention1. Primary prevention reduces the risk of health

problems by reducing lifestyle risks or targeting high risk groups

2. Secondary prevention intervenes in the early stages of disease to reduce the impact on function and independence

3. Tertiary prevention prevents or delays disability from long term conditions.

The Self Care Continuum

Self care

Self management

Medical emergencies

Management of general health and illnesses

Shared roles for people with long term conditions

Opportunity during

recovery and rehabilitation

Primary prevention

Secondary and tertiary prevention

Self care and prevention is for everyone

Self care and prevention is for everyone…..so

• Massive cultural change• Turning round a culture started at the beginning of

the NHS and the social care system will take time• Must utilise an asset based approach which

acknowledges the strengths of people, families, carers, communities, voluntary organisations, and many more, for everyone to reach their potential.

Benefits of engaging people

Can have a positive impact on people’s• Physical symptoms and clinical outcomes • Ability to cope day by day• Attitudes and behaviours• Quality of life and health and wellbeing

The evidence that this reduces costs is variable

Self Care Myths1 It is about patients doing it themselves2 It is about making it harder for people to access services3 It is about making it easy for staff4 It is about saving money5 It doesn’t work6 It is too difficult and complicated to make the cultural change.

No clear road map for the journey

The Health Foundation says

• Foster local innovation and ownership• Use the evidence available for what works• Work with an incremental model of change• Upscale over time• Build in sustainability

What works for individuals?

What works for individuals?

• Finding out what is important to the person• Involving people in decision making• Joint goal setting, plans and reviews• Structured information• Self monitoring symptoms and escalation plans• Support with social, emotional and physical

impacts of illness• Opportunities to share and learn from others

The house of care

What are we doing in AW&C?• Promoting the self care and prevention message• Working with staff teams across the area• Co creation with service users• Linking with partner organisations for win win• Establishing a staff self care network• Improving self care information on the CCG public

website• Reviewing the health navigators role for signposting and

support

Current projects include• Obesity and diabetes prevention and early

intervention• Changing approaches for people with long

term conditions• Falls prevention pathway• Self management elements in patients

escalation plans• Self harming alcohol users

For spread and sustainability• Launch of the self care network and toolkit• Planning for Self Care week in November• Including in service specifications eg Integrated

Community Services• Building into the New Models of Care• Involving more groups and stakeholders• Develop self care and prevention champions• Spread good practice and success

Bradford District and Craven Self Care and Prevention Programme

• The work streams will include – empowering the population, – developing the workforce and – technological solutions

• Bradford Public health have invested £200K– Programme manager and admin support– Communications and marketing– Training and development– Business analysis and evaluation

Question time?

References1. Person Centred Care: From ideas to action, The Health Foundation, October

20142. The Self Care Continuum adapted from the Self Care Forum Website3. The need for an integrated approach to supporting patients who should self

manage, Jim Phillips, Self Care Journal, March 20124. Delivering better services for people with long term conditions: Building the

house of care, The Kings Fund October 20135. Bradford District and Craven Self Care and Prevention Programme Brief. May

20156. The NHS Constitution March 20137. Five Year Forward View October 20148. The Health and Social care Act 2012