Delivery of EPP in England
description
Transcript of Delivery of EPP in England
Information Line 0845 606 6040www.expertpatients.nhs.uk
Information Line 0845 606 6040www.expertpatients.nhs.uk
Roy JonesIndependent AdvisorEPP Implementation GroupBackground Arthritis Care and local Voluntary sectorECLN Associate
Information Line 0845 606 6040www.expertpatients.nhs.uk
Delivery of EPP in England
• Role out through PCTs
• 28 teams
• 98% of PCTs active ( 4 refused)
• 750+ courses delivered
• 10,000+ participants
• Average 14 start
• 10 complete 4 sessions or more
Information Line 0845 606 6040www.expertpatients.nhs.uk
Activity of participants pre course
37
25
18
7
0
5
10
15
20
25
30
35
40
%
retired not active unable to workdue to illness
paid employment part time vol work
Information Line 0845 606 6040www.expertpatients.nhs.uk
Number of chronic conditions per participant
24%
28%
20%
12.60%
8% 7.50%
0%
5%
10%
15%
20%
25%
30%
1 2 3 4 5 6
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Participation by ethnicity
6.9
93.1
0
20
40
60
80
100
%
Black & minority ethnicgroups
white
Information Line 0845 606 6040www.expertpatients.nhs.uk
Age profile
0
5
10
15
20
25
30
%
18-25 26-35 36-45 46-55 56-65 66-75 76-85 85+
Age
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Arthritis 39%
CHD or vascular disease 32%
Back pain or other pain 26% Diabetes 18%
Depression, anxiety or mental
Asthma or respiratory disease 13%
Main conditions reported
ME / chronic fatigue
Multiple Sclerosis Irritable Bowel Syndrome Psoriasis
Polio Cancer Epilepsy 0ver 300+ conditions
reported
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Mainstreaming EPP as part of a integrated
chronic disease strategy
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Secondary careElective surgery
rehab
Secondary careElective surgery
rehab
Benefits & employment
Benefits & employment
Condition specific treatment plan, education &
management
Condition specific treatment plan, education &
management Primary carePrimary care
Home based treatment
and monitoring systems
Home based treatment
and monitoring systems
Voluntary sector
agencies
Voluntary sector
agencies
Social servicesSocial services
EPPSelf management
skills
EPPSelf management
skills
Patient forumsPPI
Patient forumsPPI
Private sectorservices
Private sectorservices
Information Line 0845 606 6040www.expertpatients.nhs.uk
Mainstreaming EPP
• Needs to “part of how we do things”
• A key tool for developing equity• A partnership between local patient
organisations and PCTs
• Consistency and flexibility
Information Line 0845 606 6040www.expertpatients.nhs.uk
We will provide• Teams will stay in place for next 2-3 years• Translation of core materials• Support on working with different cultural and social
economic groups• Consultancy and examples of good practice in developing
effective condition specific education.• A internationally recognised quality assurance framework
developed with LMCA.• Training and support to all organisations wishing to
develop self management• Develop learning networks to share good practice
Information Line 0845 606 6040www.expertpatients.nhs.uk
Chronic Disease Managementand the
Chronic Disease Self-management Course
• KF Managing Chronic Disease– …self-management by patients in primary care is not
unusual in high quality providers across the US…
– The NHS and in particular PCTs, could learn from this and work with patients and carers to develop the skills needed for self-management
– The EPP is beginning to encourage such approaches, but it is in its infancy and not well funded.
– Pages 41-42
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Kate MitchellAdult Services TeamDevon Social ServicesBackground in hospital social work department and interdisciplinary work
Information Line 0845 606 6040www.expertpatients.nhs.uk
Pathway with a Long-term Medical Condition
• Diagnosis of MS 7 years ago
• Used local services including MS Therapy Centre
• Read widely
• Worked with my health professionals
• Kept to diet and exercise programmes
• Who needs an Expert Patients Programme?
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What I found
• The tutors lived with MS and osteoporosis
• People owned their suggestions and acted on
them
• Mutual support from peers
• Growth in confidence
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A key choice
• Most of us had strong feelings-
– Frustration, depression, anger
• Will we be victims?
– Muddling through
• Will we exert more control?
– Practice new skills
Information Line 0845 606 6040www.expertpatients.nhs.uk
My choice
• My old excuses lost validity – Too tired– It’s too much trouble
• Fellow participants wereembracing a more positive outlook
Information Line 0845 606 6040www.expertpatients.nhs.uk
Nothing New
The programme topics include– Diet– Exercise– Relaxation methods– Finding resources in the community– Communication
It is much easier to practice these with others who are similarly affected
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Communication with Health Care Professionals
• It is easy to be overwhelmed by the frustration and, ‘There is no cure’
• The programme encouraged us to be– Realistic – Clear– Informed
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Emotional support
• One tutor was quite ill, the group provided emotional support
• She knew and valued their support because it came from people with a personal understanding of living with a chronic condition
Information Line 0845 606 6040www.expertpatients.nhs.uk
Comments from health and social care professionals
• Patients expertise is helpful• ‘Doing unto’ replaced by partnership. The patient
know his/her responsibility for making treatments work
• Active self-managers use resources appropriately• Patients regaining control encourages
professionals. Work is more enjoyable• Social workers are relieved when responding to
expressed need rather that devising services
Information Line 0845 606 6040www.expertpatients.nhs.uk
Expert Patient Power
• Teignbridge lacked physiotherapy
• Now, after negotiation:– Exercise class devised by physio delivered by
assistant– Assistant gained NVQ 3– A similar course devised for people with
arthritis
Information Line 0845 606 6040www.expertpatients.nhs.uk
Final Comments
• We can make conscious decisions about how we act. I choose to be an active self-manager
• Not everyone will be open to the concept• The courses should be available • There are benefits to participants, their
families and their health and social care workers
Information Line 0845 606 6040www.expertpatients.nhs.uk
Participants improved health status
Self reported health
Energy
Activities and social role
Health distress
Fatigue
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Aerobic exercise
Stretching and strengthening
Cognitive symptom management
Communications with doctors
Information Line 0845 606 6040www.expertpatients.nhs.uk
Person living with long term illness and their family
Condition specific treatment plan, education &
management
Condition specific treatment plan, education &
management
Peer educatorsPeer educators
Home based treatment
and monitoring systems
Home based treatment
and monitoring systems
Education and support for careers
Education and support for careers
EPPSelf management skills
Confidence building
EPPSelf management skills
Confidence building
Benefits & employment support and information
Benefits & employment support and information
Tests & Diagnosis
Tests & Diagnosis