Over the past few years there has been a push towards getting patients with long-term conditions such as diabetes to take on more responsibility for their conditions. The traditional wisdom is that GP surgeries are best placed to provide support for these patients to self-manage their care. Broadening networks Practices have a business approach to the work they do and they receive payment based on specific activities with patients, such as taking blood pressures and monitoring blood glucose levels – and these become the priorities of work in busy practices. This medically-focused attention is also what patients expect; they expect to get support in the day-to-day problems of living with a long-term condition from their family and friends rather than their nurse or GP. But if people are going to engage with managing their condition it has to make sense to them in their everyday lives. They don’t expect referrals to walking groups, for example, from their GP or practice nurse – they go to them to get biomedical advice and medications. So what does this mean for all those involved, from the patients to the professionals? While policy makers assume that individuals can be taught and supported to take responsibility for their health, in reality this isn’t happening in primary care practice – even with the five-star support and training that we provided through WISE. The problem is that if you emphasise personal responsibility without considering the support, or lack of support, people get from others you overplay it. There is also a need to improve the support and resources that patients can get from linking and connecting with social and personal networks rather than depending on support on offer from healthcare professionals – in other words widening their network of support with others who also have long-term conditions. People want to know how to manage their condition so that it does not interfere with their family and social life, their education or with their ability to work. In further research we found that people’s social involvement with local groups and personal networks (including healthcare professionals) can impact on their ability to manage a health condition – people can work out which contacts provide the best support or struggle with personal networks that are unsupportive and unhelpful. Social involvement is linked to both health and well-being more generally and the capacity to personally manage long-term conditions is improved where people learn from each other, for example with dietary and cooking tips. We feel that the future lies in focusing on ways to assist with helping people build up and use diverse and supportive networks – not just their GP. Trying to empower and motivate individuals to take on more responsibility for their health is not likely to work over the long-term. However, when we look to what networks and connections can improve access to locally available activities and support, we find it is more likely to create lasting benefits of autonomy, mutuality and reciprocity.
Posted on: Tue, 09 Dec 2014 05:45:06 +0000
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