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  • Focused on working with chronic obstructive pulmonary disease (COPD) patients.
  • Phase one ran from September 2007 until August 2010.
  • Phase two ran from 2010 until November 2012, broadening the focus geographically as well as to people with other long-term conditions.
  • Embedded the approach at all points in the care pathway for people with COPD, including at hospital and GP practices.

Overall, the aim was to introduce positive benefits from efficient self-management for patients with COPD, thereby improving people’s quality of life, helping avoid emergency admissions to hospital, and reducing the burden on the NHS. To achieve this they rolled out the three elements of the Co-creating Health programme:

  • Self-management Programme (SMP) for people with long term conditions
  • Advanced Development Programme (ADP) for clinicians
  • Service Improvement Programme (SIP) to redesign services.

Some of the findings from the three programmes were:

SMP: Recruitment to the programme was initially a challenge, however the team tested different recruitment strategies. Local advertising increased recruitment and attracted people earlier in their disease journey, offering the most potential for impact.

ADP: It was found that a critical mass of clinicians in any team was needed to embed the three components of the model so recruitment focused around whole GP practices and hospital teams. Identifying a lead for clinician development improved consistency and quality in the delivery of the ADP and also helped provide post-course support.

SIP: Employing an individual with dedicated time to spend on SIP transformed this part of the work stream. Five teams tested changes to how services are provided. In particular they were successful in introducing agenda setting in clinics and on the respiratory ward, and piloted it as part of a newly developed volunteer programme.

The success of the project led to Co-creating Health being embedded at the core of service redesign for people with long-term conditions, making it a component of all care planning within the personalisation agenda.

An added benefit was that the work has helped build excellent working relationships across primary and secondary care, demonstrating that working together for the benefit of the patient is vital.

Further reading

About this programme

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