A self-care revolution is taking place in the UK. Here, we explain how things are changing and what it means for the NHS

If you roll back the clock and consider how people manage long-term conditions such as asthma and diabetes today compared with 15 or 20 years ago, we really are entering a new era of healthcare.

These days, people are taking more responsibility for administering their own treatment, whether it is a daily injection or a peak flow test. Thanks to better training and support from healthcare professionals, people are becoming more empowered to manage their condition and improve their quality of life.

This revolution is also affecting healthcare professionals. We are moving away from "nurse knows best" to a partnership approach between healthcare professionals and patients.

Change drivers

At Skills for Health, we recognise this change and are working with partners to develop staff training and processes to deliver supported self-care. Change is being forced through due to a range of agendas:

  • Lord Darzi's review of the NHS;

  • a variety of policy drivers across UK countries;

  • personalised and patient-centred healthcare services;

  • an increase in long-term conditions and the need to help people care for themselves.

With growing levels of long-term conditions, there is a need to offer supported self-care so people can become more independent and live as normal a life as possible.

Consider a person with diabetes who competently administers their own injections at home. When admitted to hospital, this element of care is often taken out of their hands, at a time when they might most value a sense of independence. Clearly, something has to change.

Core principles

That is why Skills for Health has been working with Skills for Care to develop a set of common core principles for supporting self-care. The principles are intended to be applied by all staff across health and social care to improve understanding and enhance patient care. In a project sponsored by the Department of Health, we are running three demonstrator sites with Skills for Care looking at ways to develop integrated care packages for people. Using joined-up thinking and a partnership approach, we can identify the right competencies to:

  • encourage a better understanding of self-care among healthcare professionals;

  • overcome barriers to self-care;

  • create effective models for training.

In practice

Geraldine Granath, head of people development and teaching at demonstrator site South of Tyne and Wear primary care trust, explains the benefits they expect to see: "The self-care agenda is good for patients and good for staff. We hope this work will lead to empowerment, independence and a better quality of care for patients. Our staff will get a better understanding of what we mean by self-care, the staff role in care planning and how they can best support a patient to follow a self-care programme."

Tom Leach, workforce development consultant at demonstrator site NHS East of England, explains what they hope to achieve: "As a strategic health authority covering six counties, we look forward to shaping the implementation of supported self-care widely in the region in primary and secondary care, and ultimately helping to improve the management of patients' conditions. This work will help us to have a direct impact on the quality of patient consultation and reduce hospital admissions."

The sites will be reporting on evaluation of early results in October, when we expect to see:

  • better understanding of self-care principles;

  • identification of relevant competencies;

  • competence-based role development;

  • links into staff appraisal and reflection;

  • feedback from GP practices on the training model.

To find out more about the demonstrator sites, contact Karen Walker, divisional manager of the health policy team, on karen.walker@skillsforhealth.org.uk

For more information, see www.skillsforhealth.org.uk