title: 'It's coming at things from a very different standpoint': evaluating the 'Supporting Self-Care in General Practice Programme' in NHS East of England.
abstract: OBJECTIVE
  To undertake a service evaluation of the NHS East of England Supporting Self-Care in General Practice programme.
  
  
  BACKGROUND
  The number of people purported to live with long-term conditions continues to rise generating increasing policy emphasis on the importance of self-care. Previous work has highlighted barriers to implementing self-care interventions in general practice, including a lack of organisational approaches to providing self-care and limited engagement and training of healthcare professionals. In response to these barriers and policy drivers, NHS East of England Strategic Health Authority developed and commenced the Supporting Self-care in General Practice (SSCiGP) programme, which seeks to transform the relationships between people with long-term conditions and primary care practitioners.
  
  
  METHODS
  This was a mixed methods study, carried out over two phases, which included interviews, survey work and practice-based case studies.
  
  
  RESULTS
  This paper focuses on findings related to clinician and practice level change. Clinicians reported changes in their perceptions and in consultation practices following attendance on the SSCiGP programme. These changes were linked to empathy and patient-centredness that mirrored what patients valued in interactions with clinicians. There were qualitative and descriptive differences, but no statistically significant differences between clinicians who had and had not attended the SSCiGP programme. Time was recognised as a significant barrier to implementing, and sustaining skills learnt from the SSCiGP programme. Greater impact at practice level could be achieved when there was whole practice commitment to values that underpinned the SSCiGP programme. There was evidence that such approaches are being incorporated to change practice systems and structures to better facilitate self-care, particularly in practices who were early programme adopters.
  
  
  CONCLUSIONS
  This evaluation demonstrates that training around clinician change can be effective in shifting service delivery when sat within a cultural framework that genuinely situates patients at the centre of consultations and practice activity.
authors.affiliation: Institute for Health and Wellbeing, Leeds Metropolitan University, Leeds, UK. s.s.robertson@leedsmet.ac.uk
authors.forename: Steve
authors.initials: S
authors.lastname: Robertson
authors.forename: Karl
authors.initials: K
authors.lastname: Witty
authors.forename: Debbie
authors.initials: D
authors.lastname: Braybrook
authors.forename: Diane
authors.initials: D
authors.lastname: Lowcock
authors.forename: Jane
authors.initials: J
authors.lastname: South
authors.forename: Alan
authors.initials: A
authors.lastname: White
mesh_terms: D001291:Attitude of Health Personnel; D002908:Chronic Disease; D015897:Comorbidity; D004739:England / Q000453:epidemiology; D058006:General Practice / Q000193:education / Q000379:methods / Q000639:trends*; D006284:Health Plan Implementation / Q000379:methods / Q000592:standards; D006801:Humans; D007318:Inservice Training / Q000379:methods / Q000592:standards; D007407:Interviews as Topic; D019982:Organizational Case Studies; D017060:Patient Satisfaction; D018802:Patient-Centered Care / Q000379:methods / Q000592:standards* / Q000639:trends; D011369:Professional-Patient Relations; D015397:Program Evaluation; D036301:Qualitative Research; D012648:Self Care / Q000379:methods* / Q000523:psychology / Q000639:trends; D012944:Social Support; D013222:State Medicine / Q000592:standards / Q000639:trends