6. History
Policies aimed at modernising the NHS, produced in the last few years, have consistently emphasised the importance of the patient in both the design and delivery of services. Central to this vision of a patient-centred NHS has been the recognition that the predominant pattern of disease in this country is one of chronic rather than acute disease.
In July 1999, the Government action plan, Saving Lives: Our Healthier Nation, announced that an Expert Patients Programme would be established to help people living with a long-term condition to improve the quality of their life.
This was further endorsed by the NHS Plan, published in July 2000, which outlined a vision of a health service designed around the patient, and set out the steps necessary to achieve this, reaffirmed the establishment of an Expert Patients Programme.
The Expert Patients Task Force
The Expert Patients Task Force was set up in late 1999, with a remit to design a programme that would bring together the valuable work of patient and clinical organisations in developing self-management initiatives.
The Expert Patients Task Force was chaired by the Chief Medical Officer, Sir Liam Donaldson.
Members of the task force included representatives from the medical profession, non-governmental organisations such as Arthritis Care and the National Asthma Campaign, and experts in the fields of self-management training and research.
The Expert Patients Task Force published a report in September 2001, The Expert Patient: A New Approach to Chronic Disease Management for the 21st Century, which made a number of key recommendations, one of which was to introduce self-management training programmes for patients.
The first Expert Patients Programmes
The first Expert Patients Programmes were piloted between 2002 and 2004.
Following the success of these pilots, the NHS Improvement Plan, published in June 2004, made a commitment for the programme to be mainstreamed through the NHS in order to reach more people with long-term conditions.
The current programme
In 2005, an implementation, training and support framework, Stepping stones to success, was devised to help people and organisations develop and run lay-led self-management programmes.
Using the model of the Stanford Chronic Disease Self-Management Course, it takes volunteers through the steps necessary to becoming an accredited tutor.
The intention is to ensure that all local lay led self-management courses are delivered to a consistently high standard across the country, irrespective of who is the provider.
The framework was developed in consultation with and has been endorsed by, a wide range of voluntary and community sector providers of lay-led courses.
Latest developments
The Expert Patients Programme has been managed centrally since 2002 and implemented by primary care trusts, but Department of Health policy, as laid out in Shifting the Balance of Power: Securing Delivery in 2001, is set to move the management and resources for healthcare from central to local control.
With the changes occurring in primary care trusts and the introduction of practice based commissioning of services, the way the Expert Patients Programme is administered and delivered is also set to change.
Continued delivery of the Expert Patients Programme is dependent on the maintenance of a national infrastructure of trainers and volunteer tutors, and a central point providing coordination, identity support and quality assurance.
The White Paper published in January 2006, Our health, our care, our say: a new direction for community services, made a commitment to establish a new community interest company (CIC) to market and deliver the Expert Patients Programme.
The community interest company will become the Expert Patients Programme's main delivery mechanism.
