What does ‘self-management’ mean?
The term self-management is a charged term in healthcare. For some patients’ they believe it means “do it yourself”, “you’re on your own” and worse still “we don’t have time for you”. So, no wonder people feel frustrated when self-management is brought into the conversation. The problem here is that we have failed to communicate what self-management is really about. We’ve not told people the true meaning of self-management and the impact it can have. So, let’s be clear about what self-management means, why we have it, and how it can improve quality of life.
What is self-management?
Self-management is about empowering individuals to take control of their condition to help them feel better and have a better quality of life. We need self-management as part of healthcare because a person with a chronic illness – diabetes for example – will only see healthcare professionals for a few hours every year. The rest of the time, the person is on their own – they are self-managing. During this time alone, patients have to cope with whatever their condition throws at them. And who knows when the next appointment will be? To expect an individual with a chronic condition to immediately cope with a new disease and its impact is naïve. That’s why we are discussing self-management as part of our healthcare. Instead of leaving people to cope, the NHS wants to give people the tools they require to feel empowered and positively cope.
Patients are already trying to self-manage well on their own. Instead of expecting them to find all the information and support they need alone (as we have been doing), the NHS wants to integrate it into care plans. This is in the form of self-management support teams. They will be implementing all sorts of tools to help a person manage their condition. But anecdotal information from patients on social media, suggests that in some instances, these support teams aren’t quite working.
Why is self-management being introduced?
Self-management is being introduced as part of a new model of healthcare to cater to our population’s needs. Our current healthcare provision model was made for acute problems, conditions where people only needed one-off care, illnesses had an easily found source and – most importantly – the patient could be cured. This doesn’t fit our population’s needs anymore. Millions of people in the UK live with a long term chronic condition. They will need continuous care and can’t necessarily be ‘cured’. We have also had a surge in mental health cases. We can’t resolve mental health problems with one visit to the hospital, nor can we find the cause of it on an X-ray. These modern problems need new solutions. And self-management is one of them because living with long-term health conditions requires patients to have control and be engaged in their care.
What does self-management involve?
The NHS is setting up self-management support teams. These teams will provide people with the tools they need to manage their condition. These services hope to hit 4 key areas to make sure people can cope:
Making the person believe they can succeed at a task.
When people have just been told they have a chronic condition they are likely to feel overwhelmed. Someone can give them all the tools to manage the condition, but if they don’t feel capable, they won’t succeed. Giving someone confidence in their ability to cope can involve telephone coaching services, discussions with supportive healthcare professionals and peer support from people who also have the condition.
2. Improving technical skills
For example, we can teach a person how to take their blood pressure or blood sugars. If they can perform these tasks on their own, then they can better understand and monitor their condition. Patients could also be taught about the signs and symptoms of their condition. This will make it more likely that they’ll notice when something is going wrong and prevent their condition worsening. This is making an individual independent.
3. Information provision
We want to give people information about their condition and its impact. This isn’t always about the science behind the illness. Instead, it can be about how others manage the effects of the condition. This could be peer to peer support where patients can get support from people who understand their situation. Some people join social media support groups to share information with each other and offer support. The individual could also have easy access to their NHS records, helping them to keep up with their health and care instead of having to be reliant on healthcare professionals.
4. Behaviour Changes
The ultimate aim is to achieve behaviour changes in the individual, a change that will help them live with their condition. If people can learn how to cope with their condition and manage when away from health-care professionals, they will have a better quality of life. A patient shouldn’t be left to be helpless when not in a hospital – that is why we are discussing self-management. Patients are already having to perform self-management. But they are having to do it with very little support and teaching from healthcare professionals.
How will self-management change my care?
The NHS is currently setting up self-management support teams. If you are someone living with a chronic condition this may mean changes to the set-up of your current healthcare provision. This may indeed, feel like abandonment. But know that the idea is to set up a greater network of support for you. Instead of only getting help through a doctor’s appointment, the NHS wants support to be available in a network around you so you can achieve autonomy over your condition.
So, what is self-management about? It’s about being self-sufficient and capable because you’ve been given tools to improve your coping style and you have lots of support to rely on. A patient should have access to peers who understand their condition and to healthcare providers who will support their condition management. And most importantly they should be able to access their skills – because they’ve been taught and shown, how to cope – mentally and physically.
Find out more about self-management – Self-Management UK
Making the person believe they can succeed at a task.