Oldham - The programme starts with who you are

'Where I live, people live eight years less than anywhere else in the country. I want to know what my health services are going to do about it,' says 59-year-old David Cartwright. He lives in Fritton Hill, Oldham, and has become involved with local health services since taking part in the Expert Patient Programme (EPP) three years ago.

He sees the EPP as something of a passport to living longer and more healthily. He is also informed and very much involved with local health services in Oldham.

Six years ago he had a heart attack and found he had heart disease. He also has diabetes, hardening of the arteries in his legs and chronic obstructive pulmonary disease (COPD). He was unable to work and do the sports he was used to doing and felt isolated.

In 2003 he took part in the programme, and found his confidence as well as his 'get up and go'.

He says: 'It has made the world of difference. It's the best thing to happen to me since Warburton's marketed sliced bread. I now have the confidence to get out and about, and I know how to build my day around my illness, so I am able to do things like cook a meal for my wife and I without feeling tired and irritable.'

Not only has the EPP helped him learn how to manage his illness, but also helped him contribute to local life. 'The programme is national, but it empowers you to do things in you own community.'

Mr Cartwright now sits on three different patient forums and is closely involved with the consultation over health services in Oldham.

His knowledge of local services means he can help friends and neighbours access the right service for them.

'Health services are for local people and if they're not being provided, we have a right to ask why not,' he says.

'Being involved is a bit like voting. If you don't vote you can't complain when services aren't delivered.'

Rosie Kingham is Patient & Public Involvement lead at Oldham PCT. She runs the EPP in Oldham. 'The programme starts with who you are rather than with your condition,' she says. 'We don't do anything specific with conditions because we don't know what's coming through the door.

'We look at people's common experiences. Things like pain, fear for the future - what's going to happen to me? - depression, isolation and frustration with others who don't understand what it's like to have a long-term condition.

'All the tutors including myself have long-term conditions, so we do know what it's like.'

Course participants learn to recognise a 'symptom pain cycle', where pain feeds tense muscles and tense muscles feed anxiety and depression, and learn to cut through the cycle and deal with the problems as they arise to prevent the cycle repeating. This might mean managing pain relief better or ensuring sufficient rest.

They also learn the skills to think positively: 'Turning things around like &Quot;I feel too tired to go out&Quot; to &Quot;I will feel better when I get there&Quot;,' says Ms Kingham.

'We also teach communication skills, and those who come on the course are definitely more confident and have gone on to other patient involvement and health service groups.

'Carers come on the course too, and they take it back to those they care for. It really is empowering.'