Supporting people to play a greater role in their own health and care clearly has benefits for GP practices – not least because it frees up time – which is why the NHS detailed Self Care and Management as the ninth action in its Releasing Capacity in General Practice initiative.
For practices, this idea is about creating new ways to support people to play a greater role in their own health and care – beginning before the consultation stage by signposting patients to sources of information, advice and support in the community. Common examples include patient information websites, community pharmacies and patient support groups. For people with long-term conditions, this involves working in partnership to understand patients’ mental and social needs as well as physical. Many patients will benefit from training in managing their condition, as well as connections to care and support services in the community.
Signposting can be a hugely valuable tool for practices – and it’s a topic we’ve covered many time before on the Practice Index Blog – click here to see more.
Elsewhere, other practices have been creating practice ‘Health Champions’, which is the case at Oxford Terrace and Rawling Road Medical Group in Gateshead. There, according to a case study on NHS Networks, patients are invited to be trained as volunteer Health Champions to engage with other patients, understand needs and organise activities.
The Champions are volunteers who work with the practice to improve services. They support service improvement, run groups for patients and help connect the practice with local voluntary groups. The practice works with them in a collaborative way, with much of the champions’ work arising from their own ideas. They also provide a source of additional capacity to assist the practice in its health promotion and outreach work.
Sheinaz Stansfield, the practice manager, reports: “This has completely changed our relationship with patients and the third sector. They are now equal partners in service redesign and planning. However, they are also a key asset to the social prescribing work we do.”
Interestingly, the majority of Health Champions have enduring mental health problems. They used to take up significant GP resource, but they are now running self-help groups and contributing to other community services and living more independent lives. They make fewer appointments with the GP.
Sheinaz reports that working with the champions has made it easier for the practice to encourage patients with social issues to turn to the community rather than the GP.
Dr Caroline Snell, GP, admits to initial reservations about Practice Health Champions but is now supportive. “I wondered how many patients would be interested because it’s a huge commitment. But it has been a success.
“My regular patients have had great support and they’re coming to see me less and less. I now have options for signposting people, especially those with mental health problems. We have groups for befrienders, knitters, readers…all run by champions. With lack of resources and, increasingly, lack of GPs, we have to encourage self-care.”
The team at Oxford Terrace and Rawling Road Medical Group have shared a number of tips for other practices considering Practice Health Champions, which are:
• It’s OK to start small with this kind of work, and allow things to grow organically.
• It’s very important to allow volunteers themselves to contribute ideas, shape priorities and, ultimately, choose what they want to do – but prepare to be pleasantly surprised at the practicality of their interest.
• Practice staff can help with recruiting champions, but often the champions themselves are the best recruiters, along with other voluntary groups in the local community.
Utilising Patient Health Champions isn’t the only way to drive improved self care:
• Practices up and down the country are increasingly involved in supporting patients with minor ailments to care for themselves. This often includes providing advice and signposting to services provided by community pharmacy.
• Education also plays a part, with growing numbers of practices contributing to efforts to teach people about the best ways to seek help when ill. This often begins with engagement in local primary schools.
• For people with long-term conditions, a more proactive approach to care is being adopted, alongside a concerted effort to help people play a more active role in monitoring and managing their condition. Initiatives may include the use of health coaching in clinical consultations and the provision of training and support in the community, aiming to build the knowledge, skills and confidence for patients and carers to manage their condition.
Finally, a useful resource to turn to when thinking about social prescribing and self care is from the Self Care Forum – they’ve published a series of Top Tips for Practices in Supporting Self Care, which is well worth a read. Click here to access the list.