Improving health outcomes through supported self-care

15 Feb 2016 Sam Brown

A new report co-produced by Bristol Community Health suggests that patients may benefit from using a package of technology, education and support from clinicians (called ‘supported self-care’) to empower them to manage their health needs more effectively at home.

The report highlights the outcomes of an eight month Champion Project where supported self-care was implemented with a small cohort of patients in one GP surgery in Bristol. We ran the project in partnership with Philips Healthcare, The Lennard Surgery and funded by the West of England Academic Health Science Network.

93 patients were enrolled at three different levels of service, depending on the severity of their condition and level of care that they required, and their personal preferences. Different technologies were offered to patients, to enable them to learn more about their condition and/or submit vital readings in their own home. All three levels of service were connected to a clinical hub, enabling staff to monitor readings and provide further support as required.

At the end of the year, a range of outcomes were reported.

  • GP practice contacts (visits, phone calls) reduced by a third for all patients.
  • Patient activation levels increased by 38% to 56%.[2]
  • 98% of patients would recommend the service to family and friends

Due to the small sample size, no statistical claims are made of this data, but the results are consistent with statistically significant results obtained elsewhere. A range of positive benefits was also reported through interviews with patients: “It’s made me more aware of my own condition; I’ve learnt to read the signs. I’m able to judge when I need to contact someone,” said one patient. “I’ve found it reassuring – this scheme gives you confidence,” said heart failure patient Gordon Hennessy. “If there’s anything wrong my nurse will pick it up or my doctor will pick it up.”

The partnership is now exploring whether an extended model for supported self-care, involving patients with differing health conditions, might be feasible across the whole city. To aid this, two new videos have also been released to explain the concept of Supported Self-Care to GPs and local commissioners.

Access the commissioners’ video here.
Access the GPs’ video here.

Lennard Surgery Practice GP Dr Gareth Ronson said: “I know from directly talking to patients how much they appreciated the monitoring and how much confidence it gave them to manage their condition at home. Just this week, I visited a gentleman who was sad to see the project finish but had continued to record his data despite the end of the project, and he directly commented on his increased confidence. I’m sure there will be more of this type of Supported Self-Care in the future and it will help motivate and support patients to improve their medical conditions.”

Julia Clarke, Chief Executive of Bristol Community Health said: “We’re really excited by the outcomes of our supported self-care partnership project. There’s a growing and important role for technology and education in empowering patients to take control of their own health, and these initial outcomes support this. Our vision for the future is one where patients are able to self-care as much as possible, in the comfort of their own home, and with support from community healthcare staff, and contacts with GPs and hospitals is minimised. This work will help us achieve that.”

Malcolm Hart, Senior Director of Hospital to Home at Philips said: “This collaborative project has demonstrated valuable new insights on how people living with long term conditions can be supported to self-care more effectively. This is a win-win for patients and the health system– better quality of life, and improved health outcomes, at lower cost.”

Dr Elizabeth Dymond, Deputy Director of Enterprise and Translation said: ““The West of England Academic Health Science Network was delighted to co- fund the Champion Project. We are always keen to support innovative projects, especially those encouraging people to be more informed and involved in in managing their long term health conditions.”

To access a full copy of the report Supported Self-care through technology: a population approach to long term condition proactive management in the community, please email gemma.hargreaves@briscomhealth.nhs.uk.

 

[1] Eklind,. H. and Van Berkel, C. (ed.) 2015. Supported Self-care through technology: a population approach to long term condition proactive management in the community. Bristol: Bristol Community Health.

[2] Patient activation is a measure of a person’s skills, confidence and knowledge in managing their own health.