Thames Valley LPCs Conference November 6 th 2011 Supporting Patients to Self Care Rachel Martin

1. Thames Valley LPCs Conference • November 6th 2011 • Supporting Patients to Self Care • Rachel Martin • Assistant Director QIPP Delivery, LTC and Self Care

2. What do we mean? • Self Care is: • An integral part of daily life and is all about individuals taking responsibility for their own health and well-being. • It includes staying fit and healthy, taking action to prevent illness and accidents, using medicines effectively, treating minor ailments appropriately, and seeking professional help when necessary. • Self Management is: • A term used specifically for patients living with a long term condition – “the individual’s ability to manage the symptoms, treatment, physical and psychosocial consequences and lifestyle changes inherent in living with a long term disorder”.

3. You are vital • Community pharmacists have a key role to play in both: • Providing ongoing support to patients who are living with disease for life, in an easily accessed , informal setting • Providing medicines and ensuring patients are able to self administer these appropriately and effectively • Providing lifestyle advice and support • Helping patients become pro-active in managing their own health

4. Why does it matter? • Around 15 million people in England have one or more long-term conditions. • The number of people with multiple long-term conditions is predicted to rise by a third over the next ten years • People with long-term conditions account for 50 per cent of all GP appointments and 70 per cent of all inpatient bed days • Treatment and care of those with long-term conditions accounts for 70 per cent of the primary and acute care budget in England • King’s Fund, Top Ten Priorities for Commissioners, 2011

5. …and • Around 70–80 per cent of people with long-term conditions can be supported to manage their own condition

6. Self management • Has potential to improve health outcomes in some cases, with patients reporting increases in physical functioning (Challis et al 2010). • Can improve patient experience, with patients reporting benefits in terms of greater confidence and reduced anxiety (Challis et al 2010). • Has been shown to reduce unplanned hospital admissions (Purdy 2010) and to improve adherence to treatment and medication (Challis 2010).

7. The Oxfordshire Approach • Aim interventions at the LTC population – not focussed on general health maintenance or minor ailments • Patient and Carer Education programmes • Self care planning • Workforce development

8. Patient and Carer education Confidence to Care 5 session programme Targeted at people with a long tern caring responsibility Focus is on looking after yourself so you are able to go on caring Carers encouraged to form informal support networks Pharmacists can actively promote • Choosing self management for life • 7 session programme • Targeted at patients with 1 or more long term condition • Focus is on understanding what it means to live with a condition for life, and how you can take control of it, rather than it having control of you • Patients encouraged to form long term informal support networks • Pharmacists can actively promote

9. Self Care Planning • Way to encourage patients to think about what they want to change about their lives – starts from who the patient is and how s/he lives, and not what the patient has • Takes a person through a structured thought process that helps them set manageable and achievable goals • Developed in partnership with a healthcare professional who can help them stay motivated and who can ensure plans are clinically sensible • Includes crisis management plan for the underlying physical condition(s) • Electronic or written plan that patient can share with a number of professionals • A way for pharmacists to improve medication compliance and take up of funded services like weight loss, smoking cessation and other health improvement programmes • Pharmacists could promote, or act as lead professional to support self care

10. Workforce education • Our health system diagnoses and treats symptoms of disease, but it is as people that we self manage – so we need to provide patient centred care

11. Supporting Self Management for Life • Seeing the world from the patient’s perspective • Learning to tap into the patient’s motivation to change • Communicating in ways that enable you to engage, and therefore inform, your customers…and keep them coming back to you • Supporting self care planning • Courses on two levels - for pharmacists and for counter staff

12. To sum up • More than any other health profession, everything you do either is, or has the potential to be, about self care • How you communicate with patients can have a really big influence on how they behave – but working with patient’s differently may push you out of your own comfort zone • Community pharmacy has the expertise, space, opportunity and time to make a big impact in this area • A patient who is supported to improve their life and health is a customer who will come back