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. 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 control 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 illness 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 manage, 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. Support teams will help us with self-management and provide tools to help a person manage their condition. But anecdotal information from patients on social media suggests that these support teams aren’t quite working in some instances.
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 model was designed to cure patients and deal with one-off- complications. The model 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 its cause on an X-ray.
These modern problems need new solutions. Self-management is one of them because living with long-term health conditions requires patients to 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 four key areas to make sure people can cope:
Self-efficacy means 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 illness, but they won’t succeed if they don’t feel capable. 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
We can teach a person how to take their blood pressure or blood sugars, for example. If they can perform these tasks independently, they can better understand and monitor their condition. Patients could also be taught about the signs and symptoms of their condition. Educating patients means that they are more likely to notice when something is going wrong and prevent their condition from worsening.
3. Information provision
We want to give people information about their condition to understand and manage symptoms. Information can come from various sources, including peer support, where patients can learn from each other. For example, some people join social media support groups to share information and offer support. Additionally, people can also have easy access to their NHS records, helping them keep up with their health and care instead of relying on healthcare professionals.
4. Behaviour Changes
The ultimate aim is to achieve behaviour changes in the individual, which will help them live with their condition. If people can learn how to cope with their situation and manage when away from healthcare professionals, they will have a better quality of life. Healthcare professionals still need to offer people support, guidance, advice and monitoring to ensure patients build their confidence to participate in self-management. We say participate because their clinical teams should still help patients.
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 your current healthcare provision’s set-up. 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. The danger is that some people may start to feel abandoned to cope with their illness independently, but that is not the case. The idea is to create a greater network of support for you.
Find out more about self-management – Self-Management UK