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Delivery of EPP in England

Roy Jones Independent Advisor EPP Implementation Group Background Arthritis Care and local Voluntary sector ECLN Associate. 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

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Delivery of EPP in England

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  1. Information Line 0845 606 6040 www.expertpatients.nhs.uk

  2. Roy JonesIndependent AdvisorEPP Implementation GroupBackground Arthritis Care and local Voluntary sectorECLN Associate Information Line 0845 606 6040 www.expertpatients.nhs.uk

  3. 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 6040 www.expertpatients.nhs.uk

  4. Activity of participants pre course Information Line 0845 606 6040 www.expertpatients.nhs.uk

  5. Number of chronic conditions per participant Information Line 0845 606 6040 www.expertpatients.nhs.uk

  6. Participation by ethnicity Information Line 0845 606 6040 www.expertpatients.nhs.uk

  7. Age profile Information Line 0845 606 6040 www.expertpatients.nhs.uk

  8. Arthritis 39% CHD or vascular disease 32% Back pain or other pain 26% Diabetes 18% Depression, anxiety or mental Asthma or respiratory disease 13% ME / chronic fatigue Multiple Sclerosis Irritable Bowel Syndrome Psoriasis Polio Cancer Epilepsy 0ver 300+ conditions reported Main conditions reported Information Line 0845 606 6040 www.expertpatients.nhs.uk

  9. Mainstreaming EPP as part of a integrated chronic disease strategy Information Line 0845 606 6040 www.expertpatients.nhs.uk

  10. Secondary care Elective surgery rehab Voluntary sector agencies Condition specific treatment plan, education & management Primary care Benefits & employment Home based treatment and monitoring systems Social services Choices EPP Self management skills Patient forums PPI Private sector services Information Line 0845 606 6040 www.expertpatients.nhs.uk

  11. 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 6040 www.expertpatients.nhs.uk

  12. 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 6040 www.expertpatients.nhs.uk

  13. Chronic Disease Managementand theChronic 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 Information Line 0845 606 6040 www.expertpatients.nhs.uk

  14. Kate MitchellAdult Services TeamDevon Social ServicesBackground in hospital social work department and interdisciplinary work Information Line 0845 606 6040 www.expertpatients.nhs.uk

  15. 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? Information Line 0845 606 6040 www.expertpatients.nhs.uk

  16. 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 Information Line 0845 606 6040 www.expertpatients.nhs.uk

  17. 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 6040 www.expertpatients.nhs.uk

  18. My choice • My old excuses lost validity • Too tired • It’s too much trouble • Fellow participants were embracing a more positive outlook Information Line 0845 606 6040 www.expertpatients.nhs.uk

  19. 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 Information Line 0845 606 6040 www.expertpatients.nhs.uk

  20. 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 Information Line 0845 606 6040 www.expertpatients.nhs.uk

  21. 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 6040 www.expertpatients.nhs.uk

  22. 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 6040 www.expertpatients.nhs.uk

  23. 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 6040 www.expertpatients.nhs.uk

  24. 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 6040 www.expertpatients.nhs.uk

  25. Participants improved health status Self reported health Energy Activities and social role Health distress Fatigue Information Line 0845 606 6040 www.expertpatients.nhs.uk

  26. Aerobic exercise Stretching and strengthening Cognitive symptom management Communications with doctors Information Line 0845 606 6040 www.expertpatients.nhs.uk

  27. Tests & Diagnosis EPP Self management skills Confidence building Education and support for careers Peer educators Person living with long term illness and their family Home based treatment and monitoring systems Condition specific treatment plan, education & management Benefits & employment support and information Information Line 0845 606 6040 www.expertpatients.nhs.uk

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