• Aimed to embed self-management support within mainstream health services across the UK
  • Worked across eight sites between 2007-2012
  • Each site focused on one of four clinical areas: COPD, depression, diabetes and musculoskeletal pain.



The NHS is under increasing pressure to improve quality and reduce costs. And research has shown that supporting people to self manage their condition improves their quality of life and helps to save costs.

The Co-creating Health programme aimed to embed self-management support within mainstream health services across the UK and equip individuals and clinicians to work in partnership to achieve better outcomes.

The programme focused on three equally important factors which determine how much individuals are able to play an active role in managing their own health:

  • Giving people with long-term conditions the skills, confidence and support to self manage.
  • Helping clinicians to develop the skills, knowledge and attitude to support and motivate people with long-term conditions.
  • Changing health systems so that they encourage and facilitate self management.

Phase one: testing the model, building skills and evidence, 2007-10

We worked with eight NHS sites to demonstrate the best way to establish self-management support at the heart of mainstream health care.

Three training and information programmes were delivered across all sites:

  • Self Management Programme (SMP) – supported people with long-term conditions to develop the confidence, knowledge and skills they need to manage their condition while working in partnership with their clinicians.
  • Advanced Development Programme (ADP) – supported clinicians to develop the skills required to support and motivate people to take an active role in their own health.
  • Service Improvement Programme (SIP) – supported the Co-creating Health sites to change and improve the way their health services are designed and operated.

Each of these information and training programmes focused on the three enablers: goal setting, shared agenda setting and goal follow up.

Phase two: sustaining and spreading the approach, 2011-12

Seven of the original eight sites continued to worked with us to:

  • achieve local sustainability of the Co-creating Health model
  • secure the spread of the Co-creating Health model to a wider population.


Particular examples of impact include:

  • In Wandsworth, people with depression used significantly fewer consultant appointments and bed days, and had reduced anxiety and depression
  • In Haringey and Islington people with diabetes had improved clinical outcomes (glucose control, lipids and renal function)
  • In Torbay, people with depression were less likely to have consultations with specialists at the mental health trust
  • Several sites reported reduced DNA (did not attend) rates for appointments since the programme was introduced, particularly where individuals had received agenda-setting prompts prior to their appointments.