Website of the Department of Health

Harry Cayton, Director for Patients and the Public, Department of Health

"When you leave the clinic, you still have a long term condition. When the visiting nurse leaves your home, you still have a long term condition. In the middle of the night, you fight the pain alone. At the weekend, you manage without your home help. Living with a long term condition is a great deal more than medical or professional assistance.”

It is the activities that enable people to deal with the impact of a long term condition on their daily lives, dealing with the emotional changes, adherence to treatment regimes, and maintaining those things that are important to them – work, socialising, family.

Self care is one of the key pillars of The NHS Improvement Plan vision for a patient-centred care system and is an important strand to the Government's overall strategy for health. Supporting self care is essential to sustaining delivery of the PSA target in order to produce better health outcomes, slow disease progression, ensure better management of the sudden deteriorations often associated with long term conditions and result in improved quality of life for people. For people with long term conditions, self care and self management have become increasingly important in improving well-being, maintaining independence and quality of life. For example, patients with diabetes are relatively high users of health services. Yet each sufferer spends on average just three hours a year interacting with health professionals. For the remaining time, they and their families handle the daily challenges of the disease themselves.

People with long term conditions have better lives when they are supported to take care of their conditions themselves.  If people have a clear understanding of their condition and what they can do, they are more likely to take control themselves.  One of the priorities in the ‘Your health, your care, your say’ consultation was for services based around their needs which help them take control of their health, support their well-being and enable them to lead an independent and fulfilling life.

The White Paper Our health, our care, our say: a new direction for community services (January 2006) sets out a vision and package of proposals designed to address the expectations and outcomes that people want for themselves, maintaining a sense of well-being; and leading an independent life.  There is solid evidence that care is less effective if people feel they are not in control.

Three themes run throughout the White Paper:

• enabling and supporting health, independence and well-being;
• rapid and conventional access to high quality, cost effective care; and
• putting people more in control of their own health.
  

Self care lies at the heart of putting people in control and plays a key role in improving the management of long term conditions.  The self care guide for supporting people with long term conditions complements the proposals set out in the White Paper and both reinforce our existing programme of reform.
The document sets out the context for why the NHS in particular needs to embrace the philosophy of self care and advocate it, in order to support patients with long term conditions to adopt self care behaviours.  The document identifies four key areas in which patients need support (skills & training, information, tools and devices and support networks), and gives examples of good practice together with the role of patients, professionals and PCTs/Trusts in supporting these areas.  The aim of the document is to help NHS and Social Care organisations develop local self care strategies.

• Supporting people with long term conditions to self care: A guide to developing local strategies and good practice
• Our health, our care, our say