Do it yourself patients will deliver better health and fewer hospital admissions

The NHS could do more to improve the health of patients and reduce expensive hospital admissions by helping people to manage their own conditions more effectively in the community, says a King's Fund report, Self-management for long-term conditions: Patients' perspectives on the way ahead, published today.

The report argues that people with long-term conditions, such as diabetes and asthma, find it difficult to be more involved in managing their own symptoms because health services lack the flexibility to allow them to do so.

The report is based on a review of patients' perceptions about managing their own conditions and identifies how primary care trusts (PCTs) and other health and social care services can support patients in line with their individual needs.

Self-management for long-term conditions: Patients' perspectives on the way ahead, by Sara Corben and Rebecca Rosen, sets out three key challenges for the health service:

  • developing the skills of professionals to help them support patient self-management
  • providing better information about long-term conditions and the local services available
  • increasing the flexibility of services to fit in around people's lives.

Report co-author Sara Corben said:

'We need services that are tailored around people's lives - not the other way round. The role of health professionals is to ensure patients understand their condition, and to help them to manage themselves. We need better patient information, more flexible services and more skilled professionals to achieve this.'

Recent government policy on long-term conditions identifies support for self-management as a key to improving services and maintaining good health. There is evidence that effective self-management can reduce hospitalisation and A&E attendances.

But The King's Fund report warns that even though there is more awareness of the need to improve the management of long-term conditions not enough is being done to support those who want to play a more active role in managing their conditions. It also reveals that patients with long-term conditions have concerns about how care and support is provided out-of-hours; about continuity of care; and about being able to fit contact with health professionals into the rest of their lives. Patients also wanted greater use of assistive technologies, such as email, text messaging and internet-based health services.

The King's Fund chief executive Niall Dickson said:

'Today's patients want tailored, personal services that meet their needs and which allow them to take control. This approach based on self-management should enable those with long-term conditions to work with professionals to create different very kinds of service than we have been used to.'

Read the report: Self-management for long-term conditions: Patients' perspectives on the way ahead

Notes to editors: 

1. For further information or interviews, please contact the King’s Fund media and public relations office on 020 7307 2585, or 07831 554927. An ISDN line is available for interviews on 020 7637 0185.

2. Self-management for long-term conditions: Patients' perspectives on the way ahead, by Sara Corben and Rebecca Rosen, is available on The King's Fund website.

3. Millions of people in the UK are living with long-term conditions such as asthma or diabetes. Up to a quarter of those affected have more severe symptoms and are at higher risk of hospital admission. Most, however, are leading full and active lives with only occasional contact with health professionals and provide much of their care themselves, altering drug doses and adapting their lifestyles in response to subtle changes in symptoms. These decisions and behaviours constitute ‘self-management’ of long-term conditions and affect a patient’s overall health and well-being significantly.

4. This King’s Fund report has been written in response to growing interest among policy makers, clinicians and patients in self-management of long-term conditions. It forms part of a wider programme of work the King’s Fund is conducting on long-term conditions covering:
• the identification of people at highest risk of ill health
• the effectiveness of case-managing people at high risk of hospital admission
• qualitative studies of health care use by people with long-term conditions
• work on the impact of current incentives on people with long-term conditions.

5. The King’s Fund is an independent charitable foundation working for better health, especially in London. We carry out research, policy analysis and development activities, working on our own, in partnerships, and through funding. We are a major resource to people working in health, offering leadership development programmes; seminars and workshops; publications; information and library services; and conference and meeting facilities.