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

2. Agenda 2.00 - 2.10pm Hannah Robertson Introduction 2.10 - 230pm
Linda Gibson
Supporting Self Management in Rheumatology pm
Scott Nicoll and Chris Smillie
Linkworkers and their role pm
Ann Gold
Overview of Self Management in Diabetes. pm
Tea/coffee pm
Mary McCallum
Physical Activity in the Vascular clinic pm
Imran Arain
Health point referral in the surgical wards pm
Discussion
How to improve supported self management in your service pm
Feedback and feedforward

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

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 medicine QOF
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
Evidence based medicine QOF

8. 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
“There’s a world of difference between truth and facts. Facts can obscure the truth.” Maya Angelou

10. Definitions
Self Management - management of or by oneself; the taking of responsibility for one's own behaviour and well-being.
Self-management support 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 !