Welcome to Self Management for Secondary Care 19 June 2019

1. Welcome to • Self Management for • Secondary Care • 19 June 2019 Dr Hannah Robertson Consultant in Diabetes and General Medicine Secondary Care Diabetes MCN Lead Self Management Clinical Lead

2. Agenda

3. Your Aims for today

4. Aims of today • To gain an overview of what projects have been on going in secondary care context • To reflect on own practice  to improve self management support in patients • To consider where opportunities lie in in your department • To feedforward ideas for developing self management agenda in secondary care

5. Why? • Why are we here today? • To save people’s lives? Or.. • To help people get better

6. Why is it important to me as a clinician? “I’ve learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel”. Maya Angelou

7. Evidence based medicineQOF Made decisions about patients whose lives we know little about based on information gathered often many years prior to the decision being made and often from evidence gathered from people who have little in common with the patient in front of you BUT It is often the best knowledge we have available, it is the safest way we obtain this knowledge and is more objective than simply our experience. As such, we have as a medical culture, given rise to the expectation that patients should adhere to advice eg

8. “There’s a world of difference between truth and facts. Facts can obscure the truth.”Maya Angelou • More involved in decisions • More satisfied with care • Improved knowledge and understanding of condition • More accurate risk perception • Improved confidence and coping skills • ½ want to be more involved in decisions • 20% unhappy with lack of information • 30 – 50% take meds as prescribed • Patient outcomes poorer than clinical trials

10. Definitions Self Management - management of or by oneself; the taking of responsibility for one's own behaviour and well-being. Self-managementsupport is the care and encouragement provided to people with chronic conditions and their families to help them understand their central role in managing their illness, make informed decisions about care, and engage in healthy behaviours. Ask not only what the health service can do for you, but what you can do for your health!”

11. Grampian Self Management • Supported Self Management Transformation Board • Grampian Self Management Network • Care and support planning through House of Care • Chris Littlejohn – Deputy Director Public Health • Linda Duthie – Public Health Manager • Alison Hannan - Self management Project Manager

13. Grampian Self Management Network • Since 6 meetings 2016 across Grampian • Mixed forum for practitioners (Health, Social Care and Voluntary sector) and people with lived experience. • a flexible and evolving entity being shaped by its members • Benefits for members: learning, sharing, supporting best practice • Benefits for wider systems: a collaborative resource, able to influence and support organisational changes eg Clinical Strategy

14. House of Care • Change in system set up in primary care • Training for admin staff • Training for clinical staff • Need for champion/leadership • 4 trainers in Grampian with support from Year of Care partnership

15. Secondary Care Multiple initiatives within departments and broader remit – eg elective care and modern outpatient agenda Areas for development: • To share good practice, to learn from experiences and challenges and to facilitate collaboration across secondary care, thus improving patient care by supporting them to self-manage. Future developments • Developing network • Offer training opportunities • Ongoing shared learning • CPD and team opportunities • Role of IT, patient portal and modern outpatient agenda as well as elective care centre • Undergraduate input • Conference 10 Oct – Save the date!

16. And now over to you !