Work Strand 1 - Physical Health

Supporting People with Physical Long Term Conditions

What is Physical Health?

The term  physical long term health condition  usually refers to prevalent chronic diseases such as diabetes, asthma, arthritis, heart disease, hypertension, chronic obstructive pulmonary disease (COPD) and other recognised conditions, which create similar needs and challenges for people. Despite the clinical differences across these long-term medical conditions, each condition confronts people and their families with the same spectrum of needs: to alter their health behaviour; to deal with the social and emotional impacts of their condition or disabilities, and even the possibility of approaching death; as well as coping with issues around transport, housing, employment, education, benefits, pensions and understanding and managing not just the condition, but its impact on people's  lives.

Most people diagnosed with a physical long term health condition often react with shock about their condition, while others are sometimes "paralysed" with anxiety. Similarly, many people feel extremely helpless and overwhelmed after the initial shock.  Our organisation provides self management services that enhance quality of life by promoting the physical, psychological, emotional, and social well-being.  When people often leave the clinic/hospital to go back into the community is often without much psychological and social support. People sometimes require a great deal more than medical or professional assistance. People require that they are better supported in managing their condition and maintain those things that are important to them - work, socialising, family life etc.

Our organisations' open door policy of supporting people with a physical long term health condition is in line with the government's initiative set out in  "The NHS Improvement Plan: Putting People at the Heart of Public Services and the policy document Supporting People with Long Term Conditions - An NHS and Social Care Model to support local innovation and integration. Additionally, it is also in line with the government's identification of long-term conditions as one of the three top priorities for the NHS. In addition, local level research suggest that people with long-term conditions are more likely to see their GP, be admitted to hospital, and stay in hospital longer than people without long term conditions. It is therefore imperative that physical long term condition is tackled at grassroots level.

Our organisation draws on the government's approach of levels of support for people with long tern conditions.
The Government's approach to long-term conditions has identified three levels of support. See graph below.

For the small number of people with the most complex needs (Level 3), the aim is to offer case management in the form of community matrons. Case management is intended for patients with multiple conditions who are most likely to be admitted to hospital or become ill unless their needs are anticipated and addressed. People with less complex needs (Level 2) are offered disease management support through the primary care team and with specialist intervention when appropriate. A specialist nurse will often provide care for these people or other professional trained in the condition concerned. For the majority of people with long term conditions, self-management care pathways (level 1) have been shown to be effective in improving quality of life and promoting appropriate utilisation of services.

Our organisation operates at supporting people with Long Term Conditions helping people to self-manage their conditions and to use health services less often.

What is Self Management

Self management is often synonymous with self care therefore in order to differentiate between the two, it is important to draw a distinction.

Self Care and Self-Management

Self-Care and Self-management have been used interchangeably in the past. However, The Department of Health defines self-care as being:

about individuals taking responsibility for their own health and well-being. This includes: staying fit and healthy, both physically and mentally; taking action to prevent illness and accidents; and the better use of medicines and treatment of minor ailments.

The term self-management, which our organisation focuses on, is related specifically to living with a long term condition and has been defined by Department of Health as: "The individual's ability to manage the symptoms, treatment, physical and psychosocial consequences and lifestyle changes inherent in living with a long term disorder."

Self-management is therefore classified as a sub-set of self-care. However, it is important to emphasis that our mission is concerned with self-management. It is against this background that we have established many exceptional key self management approaches to support people.  Developing theses approaches is set by high levels of deprivation within many London Boroughs with corresponding ill health, highly diverse communities, and anticipated population growth.

Overall, these key self management approaches build on the successful drive to improve quality of life, supporting the continuing shift towards improved health outcomes, reduction in health inequalities and ever-increasing focus on the patient experience.

Our Organisations' Models of Key Self Management Pathway Strategies for Physical Health

Models of key self management strategies used by Health Psychology Management Organisation Services (HP-MOS)