Supporting self-management: A guide to enabling behaviour change for health and wellbeing using person- and community-centred approaches

Philippa Lynch

This guide, published by NESTA, was written by Hannah Burd and Michael Hallsworth of The Behavioural Insights Team as part of the work of the Realising the Value programme. It outlines how the science of behaviour can help people to self-manage their health and wellbeing.

The guide is written for people who support those living with long-term conditions, or who help people avoid these conditions using person- and community-centred approaches. This group may include health, care and wellbeing professionals, people in voluntary or community groups, peer supporters, carers, patient leaders and people living with long-term conditions themselves.

The guide uses the EAST framework to organise ideas and examples. The core message of EAST is that if you want to encourage a behaviour, you should make it Easy, Attractive, Social and Timely.
The guide features a number of low-tech, pragmatic and manageable activities which can increase the spread of person- and community-centred health and wellbeing programmes.

This action-focused guide is part of the NHS England-funded Realising the Value programme, which seeks to develop person- and community-centred approaches for health and wellbeing. The programme is doing so by building the evidence base and developing tools, resources and networks to support the spread and impact of these approaches. This guide offers two things: a framework for understanding and changing behaviour, and real-world examples of how these changes happen in practice

The guide is supplemented by a second action-focused guide: Spreading Change which was written for people who champion these approaches in health and social care, in other statutory bodies and in community-based organisations.

The Guide does not appear to encourage empowerment of the individual as an aspect of the behavioural change suggested in respect of health and wellbeing? The Power of Information initiative published in May 2012 indicated that online access by Users of Health & Social Care to the information which is held by all service providers would enhance health and wellbeing (as well as ensuring that the information/data held is accurate and free from inaccuracies). Unfortunately there continues to be a culture of "we will sort it out for you, with the help of the community, but we will not allow you to be empowered by have online access to the records/information that we have decided to hold about you". Imagine if a person's Financial Health were to be 'looked after' in a similar manner! The individual would not be allowed to see their bank account online, and would not have any 'comfort' that their finances were accurate, but they could be supported by 'the community' taking decisions for them instead? Surely 'Physical & Mental Health' is as important as 'Financial Health' - and it is important that records are accurate - therefore all individuals should have online access to their Health and Social Care records on that basis. If no access is allowed, Health and Social Care will continue to be viewed as being 'something done to the individual without the individual', a culture which needs to change to ensure patient-centred care? GPs have started to comply with the requirements of the Power of Information, but Social Care appear to have the culture whereby they 'do things to people, without people' - IMHO that culture needs to change to help ensure a behavioural change in patients and the persons who are supporting them.

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Hi Phillipa, I'm really interested in this work as I am currently working on a parallel project looking at Cancer as a long term condition and how we can learn from current LTC practice to encourage low-risk cancer patient to self manage with support from community teams. In the last cancer has been very specialised and whilst the clinicians are ready for change they are approaching it from first principles. It would be good to encourage them to look "over the fence" into the current work going on around health and wellbeing and self management in LTCs. With amazing work going on around diagnosing cancer early and the impact that is having on the number of people surviving and living with cancer we need to radically change how we view these patients if the system is to be sustainable. I haven't had a read of this document yet but I will. Adrienne Adrienne.bean@nhs.net

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Supporting self-management: A guide to enabling behaviour change for health and wellbeing using person- and community-centred approaches

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