“I have altered the way I approach consultations with patients in two ways. Firstly, using open ended questions to elicit more from the patient than just one-word answers & encouraging them to explore thoughts/feelings which are integral to their behaviour. This is taking me time to master but I feel I am making progress.

Secondly, asking them to identify what is concerning them & what issues they feel it is important to cover at the start of the contact.

This has helped to prioritise the issues that need resolving & often provides an indication of the motivation level of the patient which can be picked up on later in the conversation”

“This can only have a positive effect on our cardiac rehab service. The patients will benefit in being listened to and their needs addressed”

“I went with my trainee, and we both found the training exceptionally good – I would rate it as the best PCT-arranged course I have been on. I think it works well for GPs particularly as it links in well with consultation models that we are familiar with. Though the tools are for long term self care, they are essentially motivational in nature and so are applicable to all consultations”

“For me the training cracked motivational training in a way no other lecture/course/book has done”

• bridge the widening gap between potential health and well being outcomes and those currently experienced by people living with LTCs
• enhance patients’ health related quality of life
• maximize resource utilisation
• robustly evaluate all interventions and disseminate learning
• impact populations affected by conditions with known associated health inequalities e.g. COPD.

Challenges include:

• measuring the impact of self management support
• identifying appropriate patient reported outcome measures (PROMs)
• acknowledgement of the impact of social factors on patients’ self management capabilities in addition to the psychological focus of many established self management programmes
• developing bespoke approaches which can challenge commissioning models
• building a shared understanding of self management.

• Successes include: Integration of self management support within rehabilitation programmes
• increases in levels of patient activation for self-management
• new training programmes for clinicians and workforces
• shifts in workforce attitudes and beliefs in favour of collaborative partnership approaches
• new tools to support self management, patient engagement and service user involvement.

• All our education programmes incorporate the values of co-production.
• Patient representation is a core element of our work, including developing education packages, tools and project steering.
• We strive to find new ways to meaningfully integrate self management support into patient pathways, supporting patients and workforces through this change.
• Testing new models of integration and finding new ways to inform commissioning structures of what patients really want and need to support themselves. For example, we have tested a process to enable citizen led change and identify priority needs for COPD services. – patients, clinicians, commissioners and the third sector worked together in a co-production workshop which resulted in mutually agreed actions for commissioners to take forward.
• We are building in self management support into current patient education programmes. This adds value and recognises the patient as an expert in their own health at minimal additional cost.
• We put the patient at the centre of everything we do – what’s important to me as well as what’s important for me.

Supporting patient involvement in service development: eliciting patient-centred information to inform commissioning of COPD services

Patient agenda setting and clinic efficiency in outpatients An individual randomized controlled trial

Investigating the feasibility of an online health resource integrated with nurse coach support for those with advanced COPD

Abstract for submission to BPS Division of Health Psychology conference, September 2013