1. Improving Outcomes by Helping People Take Control
In the next few minutes, I want to share with you a model for how we can deliver ‘no decision about me without me’ for people living with a long-term condition. The model is called Co-Creating Health. It is an evidence-based approach to supporting people to manage their long-term condition, improving their experience, quality of life and clinical outcomes and delivering a more efficient use of our limited resources.
The theory and practice of Co-creating Health

2. Co-creating Health
Achieve measurable improvements in the quality of life of people living with long term conditions and improve their experience of health services by embedding self management support within mainstream health services.
Effective self-management is very different from telling patients what to do. Patients have a central role in determining their care, one that fosters a sense of responsibility for their own health. A health services that supports people to manage their condition ensures that they have the confidence and the skills to do so.
Co-Creating Health is an evidence-based and integrated approach to supporting people to manage their long-term condition. It aims to achieve measurable improvements in their quality of life and to improve their experience of the healthcare system, embedding self management support within mainstream health services.
Since 2007, the Co-Creating Health approach has been demonstrated in 7 health economies. It initially focused on four conditions, each reflecting different aspects of long-term conditions illness – COPD, diabetes, mental health and chronic pain. Building on the foundations of the first years, the demonstrator sites are beginning to extend the approach to other chronic conditions.
©The Health Foundation

3. An Integrated Approach
Self-management Programme
Advanced Development Programme
Service Improvement Programme
Programme
Who
Role change
Focus
Patient
From passive patient to self-management
Activation and partnership: confidence and skills
Clinician
From expert who cares to enabler who supports self-management
Building clinicians’ skills and addressing attitudes
Service
From clinician-centred services to services that have self-management support as their organising principle
Embedding the 3 enablers into everyday practice by building them into systems and care pathways
Co-Creating Health delivers a better experience – for both patients and clinicians, a better quality of life for patients, better health outcomes and a more efficient use of our stretched resources by enabling patients and clinicians to take on different roles:
clinicians develop and improve the skills to support and motivate people with long-term conditions
people living with a long-term condition develop and improve their skills and knowledge to manage their own health
organisations develop new approaches that promote and support self-management.
A key part of the training programmes is that they are co-facilitated: patients and clinicians play an equal role in both the ADP and the SMP. This has been one of the most powerful elements of the programme. It visibly models and demonstrates working in partnership.

4. Becoming an active partner
The Three Enablers
Becoming an active partner
Making change
Maintaining change
Agenda setting
Identifying issues and problems
Preparing in advance
Agreeing a joint agenda
Goal setting
Small and achievable goals
Builds confidence and momentum
Goal follow-up
Proactive – instigated by the system
Soon – within 14 days
Encouragement and reinforcement
The essence of Co-Creating Health is the recognition that the health care system for people living with a long-term condition must become a health support system.
It does this by helping clinicians and patients change their roles. The clinician is no longer simply an expert who tells the patient what to do, but a professional skilled in enabling people living with a long-term condition to change their behaviour; the patient is no longer the passive recipient of care packages which they do not follow, but an activated self-manager of their condition.
Co-Creating Health makes available a range of tools and techniques to help – from agenda setting; through collaborative goal setting; to goal follow up. It trains clinicians and patients to use these tools and techniques. And it gives clinicians and managers the tools to change it change the system so that its supported self-management can be put in to practice.
In the words of one person living with a long-term condition who had been on the Self-management Programme and is supported by clinicians who have been on the Practitioner Development Programme in a hospital that has redesigned its services to support self-management: ‘I’d like to thank you both for giving me back the life I thought I’d lost, its made me realise I was holding myself back’

5. Conclusion
‘I’d like to thank you both for giving me back the life I thought I’d lost, its made me realise I was holding myself back’
SLIDE 15: Conclusion
The essence of Co-Creating Health is the recognition that the health care system for people living with a long-term condition must become a health support system.
It does this by helping clinicians and patients change their roles. The clinician is no longer simply an expert who tells the patient what to do, but a professional skilled in enabling people living with a long-term condition to change their behaviour; the patient is no longer the passive recipient of care packages which they do not follow, but an activated self-manager of their condition.
Co-Creating Health makes available a range of tools and techniques to help – from agenda setting; through collaborative goal setting; to goal follow up. It trains clinicians and patients to use these tools and techniques. And it gives clinicians and managers the tools to change it change the system so that its supported self-management can be put in to practice.
The implementation Co-creating Health in the demonstration sites is showing that it improves the quality of people’s lives and save NHS resources.
In the words of one person living with a long-term condition who had been on the Self-management Programme and is supported by clinicians who have been on the Practitioner Development Programme in a hospital that has redesigned its services to support self-management: ‘I’d like to thank you both for giving me back the life I thought I’d lost, its made me realise I was holding myself back’
Person living with a long-term condition
©The Health Foundation