National Cancer Survivorship Initiative

Central Hall, WestminsterMonday 21 September 2009

Self Management

Self Management Support WorkstreamNational CancerSurvivorship Initiative

Where are we now?

Lynn Batehup

21st September 2009

Workstream workshop - content

• The working definition of self managementand self management support

• Baseline work

• Drivers for change

• Evidence leading to a framework

• Supported self management framework

• Potential pathways for aftercare and support??

Self Management in cancer is what people do to enhance recovery and/or manage their condition.(long term)

Self Management support is what health services do to encourage cancer survivors make decisions that improve their health and clinical outcomes.(THF)

Cancer survivorship and self management:Reviewing evidence base.

• Review of evidence base for self management support for cancer survivors (and drawing on work in long term conditions) February 2008 Fenlon and Foster 2008)

• Mapping – a snapshot of services identified as supporting self management (Mar – July 2008)

• Review of outcome measures for self management support in the context of cancer survivorship April 2009 (Davies 2009)

• Updated review of the evidence for follow-up support services (Ongoing)

• Review of evidence for impact of specific lifestyle factors on cancer recovery and survival. (ongoing)

Drivers for change – self management – living with and after cancer

Self management support evidence:

1. Collaborative interaction/patient professional relationship:

Basic building block is the culture change to incorporate self

management support and use behaviour change techniques

during routine clinical practice to enhance patient’s abilities and

confidence to be effective ‘self managers’

2. Self management programmes:

Programmes can develop generic skills such as problem solving

and enhancing self efficacy, and /or be type/symptom specific.

There can be improvements in QoL, symptom management,

coping behaviour, and knowledge of condition.

3. Self management is for all:

It starts with exploring patients beliefs, knowledge, and values about

their role in self management – it’s a journey

Self management support evidence

4. Consistent Supporter

Tailored ‘support’ and follow up - ( based on periodic assessment and

a personalised care plan) in planned pathways will promote self

management – lifestyle change; effective self monitoring; event

reporting; symptom management; well being and quality of life.

5. Tackling the whole system

• Informed and active patients – able to use support

• Prepare and develop professionals – patient centred approach

• Service improvement – design and process to support self

management

Evidence: ‘Supported self management framework’:

Thank you

Lbatehup@macmillan.org.uk

Questions for feedback

• From what you have heard today, what is the most important?

• What, if anything, has been left out?

• What will be the difficulties in implementation

• How can we overcome these difficulties