Sustaining and spreading self-management support Lessons from Co-creating Health phase 2

This report contains the independent evaluation of the second phase of our Co-creating Health improvement programme. The evaluation, conducted by Firefly, provides valuable insight into how to sustain changes in clinical practice to more effectively support people with long-term conditions.

Through the Co-creating Health programme, the Health Foundation has invested £5 million over five years to test how to embed and sustain self-management support in primary and secondary care across a range of long-term conditions. The Co-creating Health model incorporates self-management training for people with long-term conditions, training in self-management support skills for clinicians, and a service improvement programme to put systems and processes in place to support patients and clinicians in their self-management activities.

Firefly’s evaluation of the programme concludes that to have the best chance of success there needs to be a strategic, whole-system approach to implementation of self-management support. The evaluation also highlights:

• the benefits of training teams rather than individuals
• the importance of support from senior leadership within the clinical community
• the added value of integrating with concurrent initiatives
• the value of providing support for both patients and clinicians after their initial self-management training as they seek to embed new habits.

The Co-creating Health model for supporting self-management can have a profound and positive effect on patients, clinicians and health services but, as the evaluation shows, making the necessary changes can be hugely challenging. However, Co-creating Health offers a theoretically robust, well evaluated model with tried and tested training, techniques and tools to successfully support people to self-manage.