The long-term evolution of a structured approach to self-management across a whole population in a county in England

This workshop will explore the long-term evolution of a structured approach to self-management access a county in England, the lessons learnt and implications for future services. Dorset has a population of just under 500,000 people. The need for effective self-management support services in Dorset is driven by its old, and ageing population. Currently, around a quarter (24%) of the population are over retirement age (65 and over), compared to the regional average of 21%, and the England and Wales average of 18% (Dorset CCG, 2016a). In the future, the number of over seventies is set to increase rapidly from around 18% to 21% by 2025. This is likely to have an impact on the incidence of LTCs and increase demand on health services. The county also has a significant rural area with areas of high deprivation alongside more affluent areas In response to these the local health authorities commissioned a county wide approach to self-management which has evolved over the years and has incorporated self-management support, health coaching and social prescribing. The service is now in its 10 year and has extensive data on impact outcomes. This probably represents some of the most robust and long-term monitoring of self-management support effectiveness The service is a comprehensive non-clinical self-management programme open to anyone with a LTC living in Dorset. Clients are able to self-refer to the service, or be referred via a primary or secondary care clinician, or by a range of community services (e.g., pharmacies). Once referred, clients are directed through a central gateway team (run by Help & Care) which is accessible via phone, email, text, and fax, and acts as the first point of contact for users. Support methods include: One-to-one health coaching (via face-to-face, telephone and e-mail support) for up to six sessions; Face-to-face group courses; Peer support groups; Information and signposting support; Online self-management support (through CEMPAC eLearning) Online peer support; and, Support for carers of clients, Social prescribing. Evaluation. The approach has been evaluated through qualitative methods using the health education impact questionnaire, patient activation measure, Warwick and Edinburgh metal wellbeing scale and interviews with stakeholders and service users. People with lived experience have been key in the design of the service and many have taken on roles in the service.