Delivering better services for people with long-term conditions
Our paper describes a co-ordinated service delivery model – the ‘house of care’ – that aims to deliver proactive, holistic and patient-centred care for people with long-term conditions.
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The Lancet (Elsevier BV)
Karen Barnett et al. 2012
Recent analysis of patient data from Scotland found that 42 per cent of the population had at least one long-term condition and 23 per cent had two or more (Barnett et al 2012).
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Barnett K, Mercer SW, Norbury M, Watt G, Wyke S, Guthrie B (2012). ‘Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study’. The Lancet, vol 380, no 9836, pp 37–43.
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Australian Journal of Primary Health (CSIRO Publishing)
Malcolm W Battersby et al. 2003
Several instruments have been developed to measure these attributes, including the Patient Activation Measure (PAM) (Hibbard et al 2005), the Patient Enablement Instrument (PEI) (Howie et al 1998), the Patient Partnership in Care (PPIC) instrument (Powell et al 2009), the Self-Management Ability Scale (SMAS-30) (Cramm et al 2012), the Partners in Health (PIH) scale (Battersby et al 2003), the Patient Assessment of Chronic Illness Care (PACIC) (Schmittdiel et al 2008) and the Consultation and Relational Empathy (CARE) measure (Mercer et al 2004), to name a few.
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Battersby MW, Ask A, Reece MM, Markwick MJ, Collins JP (2003). ‘The Partners in Health scale: the development and psychometric properties of a generic assessment scale for chronic condition self-management’. Australian Journal of Primary Health, vol 9, no 3, pp 41–52.
On page 24
Journal of Health Services Research & Policy (SAGE Publications)
Jenni Burt et al. 2012
Many integrated care pilot schemes have been launched, most of which share the same goal – a new service delivery system that leads to better outcomes for specific groups of patients (Nuffield Trust and The King’s Fund 2013; Roland et al 2012; Newbould et al 2012; Burt et al 2012; Bardsley et al 2013; Nuffield Trust and Imperial College London 2013).
On page 4
But since these groups comprise a relatively small proportion of the local population, targeting a much wider group with preventive care and self-management support is probably a better way to achieve benefits that are measurable across a local health economy (Roland and Abel 2012).
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Burt J, Roland M, Paddison C, Reeves D, Campbell J, Abel G, Bower P (2012). ‘Prevalence and benefits of care plans and care planning for people with long-term conditions in England’. Journal of Health Services Research & Policy, vol 17, suppl 1, pp 64–71.
On page 24
Health and Quality of Life Outcomes (Springer Nature)
Jane M Cramm et al. 2012
Several instruments have been developed to measure these attributes, including the Patient Activation Measure (PAM) (Hibbard et al 2005), the Patient Enablement Instrument (PEI) (Howie et al 1998), the Patient Partnership in Care (PPIC) instrument (Powell et al 2009), the Self-Management Ability Scale (SMAS-30) (Cramm et al 2012), the Partners in Health (PIH) scale (Battersby et al 2003), the Patient Assessment of Chronic Illness Care (PACIC) (Schmittdiel et al 2008) and the Consultation and Relational Empathy (CARE) measure (Mercer et al 2004), to name a few.
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Cramm JM, Strating MM, de Vreede PL, Steverink N, Nieboer AP (2012). ‘Validation of the self-management ability scale (SMAS) and development and validation of a shorter scale (SMAS-S) among older patients shortly after hospitalisation’. Health and Quality of Life Outcomes, vol 10, no 9.
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Quality and Safety in Health Care (BMJ)
J E Epping-Jordan 2004
A growing body of evidence underscores the importance of effective self-management of long-term conditions (Epping-Jordan et al 2004).
On page 3
Epping-Jordan JE, Pruitt SD, Bengoa R, Wagner EH (2004). ‘Improving the quality of health care for chronic conditions’. Quality and Safety in Health Care, vol 13, no 4, pp 299–305.
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Annals of Internal Medicine (American College of Physicians)
2012
Fan VS, Gaziano JM, Lew R, Bourbeau J, Adams SG, Leatherman S, et al (2012). ‘A comprehensive care management program to prevent chronic obstructive pulmonary disease hospitalizations: a randomized, controlled trial’. Annals of Internal Medicine, vol 156, no 10, pp 673–83.
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Journal of General Internal Medicine (Springer Nature)
Jessica Greene et al. 2012
People WHO are more ‘activated’ (that is, WHO recognise that they have an important role in self-managing their condition and have the skills and confidence to do so) experience better health outcomes (Greene and Hibbard 2012).
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Greene J, Hibbard JH (2012). ‘Why does patient activation matter? An examination of the relationships between patient activation and health-related outcomes’. Journal of General Internal Medicine, vol 27, no 5, pp 520–6.
On page 25
Health Affairs (Health Affairs (Project Hope))
Judith H. Hibbard et al. 2013
With effective support and education, evidence shows that these skills can be developed and strengthened, even among those WHO are initially less confident, less motivated or have low levels of health literacy (Hibbard and Greene 2013).
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Hibbard JH, Greene J (2013). ‘What the evidence shows about patient activation: better health outcomes and care experiences; fewer data on costs’. Health Affairs (Millwood), vol 32, no 2, pp 207–14.
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Health Services Research (Wiley)
Judith H. Hibbard et al. 2005
Several instruments have been developed to measure these attributes, including the Patient Activation Measure (PAM) (Hibbard et al 2005), the Patient Enablement Instrument (PEI) (Howie et al 1998), the Patient Partnership in Care (PPIC) instrument (Powell et al 2009), the Self-Management Ability Scale (SMAS-30) (Cramm et al 2012), the Partners in Health (PIH) scale (Battersby et al 2003), the Patient Assessment of Chronic Illness Care (PACIC) (Schmittdiel et al 2008) and the Consultation and Relational Empathy (CARE) measure (Mercer et al 2004), to name a few.
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Hibbard JH, Mahoney ER, Stockard J, Tusler M (2005). ‘Development and testing of a short form of the patient activation measure’. Health Services Research, vol 40, no 6, pt 1, pp 1918–30.
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Horne M, Khan H, Corrigan P (2013). People Powered Health: Health for people, by people and with people. London: Nesta. Available at: http://www.nesta.org.uk/library/documents/PPHforpplbyppl2.pdf (accessed on 29 August 2013). http://www.nesta.org.uk/library/documents/PPHforpplbyppl2.pdf
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Family Practice (Oxford University Press (OUP))
J. G. Howie et al. 1998
Several instruments have been developed to measure these attributes, including the Patient Activation Measure (PAM) (Hibbard et al 2005), the Patient Enablement Instrument (PEI) (Howie et al 1998), the Patient Partnership in Care (PPIC) instrument (Powell et al 2009), the Self-Management Ability Scale (SMAS-30) (Cramm et al 2012), the Partners in Health (PIH) scale (Battersby et al 2003), the Patient Assessment of Chronic Illness Care (PACIC) (Schmittdiel et al 2008) and the Consultation and Relational Empathy (CARE) measure (Mercer et al 2004), to name a few.
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Howie JG, Heaney DJ, Maxwell M, Walker JJ (1998). ‘A comparison of a Patient Enablement Instrument (PEI) against two established satisfaction scales as an outcome measure of primary care consultations’. Family Practice, vol 15, no 2, pp 165–71.
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BMJ (BMJ)
A. Kennedy et al. 2013
However, these optimistic conclusions were not reflected in the findings of several other recent studies of self-management support (Bardsley et al 2013; Kennedy et al 2013; Bucknall et al 2012; Fan et al 2012).
On page 17
Kennedy A, Bower P, Reeves D, Blakeman T, Bowen R, Chew-Graham C, et al (2013). ‘Implementation of self management support for long term conditions in routine primary care settings: cluster randomised controlled trial’. British Medical Journal, vol 346, f2882.
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Family Practice (Oxford University Press (OUP))
S. W Mercer 2004
have been developed to measure these attributes, including the Patient Activation Measure (PAM) (Hibbard et al 2005), the Patient Enablement Instrument (PEI) (Howie et al 1998), the Patient Partnership in Care (PPIC) instrument (Powell et al 2009), the Self-Management Ability Scale (SMAS-30) (Cramm et al 2012), the Partners in Health (PIH) scale (Battersby et al 2003), the Patient Assessment of Chronic Illness Care (PACIC) (Schmittdiel et al 2008) and the Consultation and Relational Empathy (CARE) measure (Mercer et al 2004), to name a few.
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Mercer SW, Maxwell M, Heaney D, Watt GC (2004). ‘The consultation and relational empathy (CARE) measure: development and preliminary validation and reliability of an empathy-based consultation process measure’. Family Practice, vol 21, no 6, pp 699–705.
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Innovation Unit
Morioka S, Farrington S, Hope P, Brett K (2013). The Business Case for People Powered Health. London: Nesta, The Innovation Unit, Private Public Ltd. Available at: http://www.nesta.org.uk/areas_of_work/public_services_lab/health_and_ageing/people_powered_health/assets/features/the_business_case_for_people_powered_health (accessed on 29 August 2013). http://www.nesta.org.uk/areas_of_work/public_services_lab/health_and_ageing/people_powered_health/assets/features/the_business_case_for_people_powered_health
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BMC Family Practice (Springer Nature)
Jenny Newbould et al. 2012
Many integrated care pilot schemes have been launched, most of which share the same goal – a new service delivery system that leads to better outcomes for specific groups of patients (Nuffield Trust and The King’s Fund 2013; Roland et al 2012; Newbould et al 2012; Burt et al 2012; Bardsley et al 2013; Nuffield Trust and Imperial College London 2013).
On page 4
Newbould J, Burt J, Bower P, Blakeman T, Kennedy A, Rogers A, Roland M (2012). ‘Experiences of care planning in England: interviews with patients with long term conditions’. BMC Family Practice, vol 13, no 1, p 71.
On page 26
Many integrated care pilot schemes have been launched, most of which share the same goal – a new service delivery system that leads to better outcomes for specific groups of patients (Nuffield Trust and The King’s Fund 2013; Roland et al 2012; Newbould et al 2012; Burt et al 2012; Bardsley et al 2013; Nuffield Trust and Imperial College London 2013).
On page 4
Nuffield Trust, Imperial College London (2013). Evaluation of the First Year of the Inner North West London Integrated Care Pilot. London: Nuffield Trust.
On page 26
Journal of Management & Marketing in Healthcare (Informa UK Limited)
Roy Powell et al. 2009
Several instruments have been developed to measure these attributes, including the Patient Activation Measure (PAM) (Hibbard et al 2005), the Patient Enablement Instrument (PEI) (Howie et al 1998), the Patient Partnership in Care (PPIC) instrument (Powell et al 2009), the Self-Management Ability Scale (SMAS-30) (Cramm et al 2012), the Partners in Health (PIH) scale (Battersby et al 2003), the Patient Assessment of Chronic Illness Care (PACIC) (Schmittdiel et al 2008) and the Consultation and Relational Empathy (CARE) measure (Mercer et al 2004), to name a few.
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Powell RP, Powell H, Baker L, Greco M (2009). ‘Patient partnership in care: a new instrument for measuring patient–professional partnership in the treatment of long-term conditions’. Journal of Management & Marketing in Healthcare, vol 2, no 4, pp 325–42.
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Richmond Group of Charities, The King’s Fund (2012). From Vision to Action: Making patient-centred care a reality. London: The King’s Fund. Available at: www.kingsfund.org. uk/sites/files/kf/field/field_publication_file/Richmond-group-from-vision-to-actionapril-2012-1.pdf (accessed on 2 September 2013). http://www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/Richmond-group-from-vision-to-action-april-2012-1.pdf
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International Journal of Integrated Care (Ubiquity Press, Ltd.)
Martin Roland et al. 2012
Many integrated care pilot schemes have been launched, most of which share the same goal – a new service delivery system that leads to better outcomes for specific groups of patients (Nuffield Trust and The King’s Fund 2013; Roland et al 2012; Newbould et al 2012; Burt et al 2012; Bardsley et al 2013; Nuffield Trust and Imperial College London 2013).
On page 4
But since these groups comprise a relatively small proportion of the local population, targeting a much wider group with preventive care and self-management support is probably a better way to achieve benefits that are measurable across a local health economy (Roland and Abel 2012).
On page 16
Disappointing results from some telehealth schemes underline the folly of assuming that the answer lies simply in the provision of more technical tools and kit, or relying on single interventions without taking account of the local context and the need for system change (Steventon et al 2012).
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Roland M, Lewis R, Steventon A, Abel G, Adams J, Bardsley M, Brereton L, Chitnis X, Conklin A, Staetsky L, Tunkel S, Ling T (2012). ‘Case management for at-risk elderly patients in the English integrated care pilots: observational study of staff and patient experience and secondary care utilisation’. International Journal of Integrated Care, vol 12, e130.
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Journal of General Internal Medicine (Springer Nature)
Julie Schmittdiel et al. 2008
Several instruments have been developed to measure these attributes, including the Patient Activation Measure (PAM) (Hibbard et al 2005), the Patient Enablement Instrument (PEI) (Howie et al 1998), the Patient Partnership in Care (PPIC) instrument (Powell et al 2009), the Self-Management Ability Scale (SMAS-30) (Cramm et al 2012), the Partners in Health (PIH) scale (Battersby et al 2003), the Patient Assessment of Chronic Illness Care (PACIC) (Schmittdiel et al 2008) and the Consultation and Relational Empathy (CARE) measure (Mercer et al 2004), to name a few.
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Schmittdiel J, Mosen DM, Glasgow RE, Hibbard J, Remmers C, Bellows J (2008). ‘Patient Assessment of Chronic Illness Care (PACIC) and improved patient-centered outcomes for chronic conditions’. Journal of General Internal Medicine, vol 23, no 1, pp 77–80.
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