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Future in Self-care Health

Dame Sally Davies, previously Chief Medical Officer for England, set the health scene for leaders in managing Long Term Conditions.

It is these conditions which will take precedence in the health service of the future, the result of an ever-growing older population with multiple medical conditions. Our only hope of managing the demands is by coaching patients to take responsibility for self-management, supported by Health Professionals and utilising technology. 

Telecoaching by frontline clinicians is the way ahead, utilising our expertise as an equitable, cost-effective and efficient intervention, enabling and supporting patients to become competent managers of their own health. Dame Davies kindly commended my approach and MovingTherapy is linked to the Department of Health Selfcare Forum.

A former Chief Executive in the NHS put it like this. The only sustainable way of living healthily longer, is if we take care of ourselves. Healthcare is like a hot air balloon. We keep pumping financial resources into it to keep it afloat but the weight in the basket is increasing and the balloon is losing height. We can't pump the air in fast enough.
We need to enable communities to generate health and well being resources.

It is heartening to hear the Chief Executive of NHS England, Simon Stevens, confirm this approach.

For many years I have specialised in promoting supported independence for the older person in the community, setting up several services in Cambridge which are integral to the health of those over 50, particularly those with Long Term Conditions.

Lifespan NHS Trust in Cambridge, one of the first Primary Care Trusts in England, pioneered many of the initiatives now familiar to us. Starting in 1998 these included Rapid Response to prevent addmission or support early discharge,  provision of Intermediate Care settings, continuing rehabilitation to facilitate return to the home, Pulmonary Rehabilitation, Falls Prevention and Upper and Lower Limb rehabilitation groups.

I worked in close conjunction with Social Services, training Care Assistents. I also realised the need to reach population groups in the community and visited Day Centres and Sheltered Housing Schemes to promote activity. Multidiscilinary Training was offered to Residential and Nursing Homes, supporting them in the care and renablement of their residents. It was consistently found that those who remained active were less susceptible to illness and had less falls, I was part of a pioneer, integrated Health and Social Service team in the North of Cambridge which was highly sucessful. We had one of the lowest uptakes of home care in the City and achieved an excellent working relationship.

My experiences were used towards informing the proposals for setting up future health services in Cambridgeshire by NHS Cambridgeshire, and which were accepted by all parties involved. The reconfiguration of the services provided by Brookfields Hospital, our local community hospital, was part of this. It is now a highly successful provider of in- and out-patient services, with a specialsed, comprehensive Falls Service. Part of this service was the setting up of a Falls Response Vechicle and Team, one of the first in the country. 

Healthy ageing is possible in the face of disabilities and disadvantages and my own experience of surmounting obstacles and developing stamina is eloquent proof of that. It is the building in of resilience that is paramount to survival today.  

My own experience of managing multiple Long Term Conditons