Saturday, 9 June 2012

Tackling Long-Term Conditions: Health and Well-being

On the 30th May I attended a conference in London about long-term conditions. It was a very interesting day with some great speakers raising some thought-provoking points! Here are my highlights and points of note . . .

  • Dr Helen Bevan discussed change management, something frequent in the NHS but useful to hear the principles, particularly the four sources of energy (intellectual, emotional, spiritual and physical) of which I think I need to find more of a balance!
  • David Behan brought up a great point that there is a mis-conception about typical patients being healthy adults with single  episodes of care. Discussing integration, he commented that "information is the key enabler of integration" and that what needs to be done is to integrate care around individuals and not just integrating organisations together.
  • Jim Easton opened by saying that the LTC problem is PERSONAL because of its scale it affects all of us, which was a emotive appeal! He went on to say that "we need to know who our patients with LTC are so they can be used as a resource for self-care and shared decision making". I don't know how these patients can be identified if they don't identify themselves as patients with LTC - GPs, nurses and community links could establish that? Encouragingly, he finished by saying that "the keystone of the future of the NHS is long-term condition management."
  • Following on from Dr Helen Bevan's point on energy within the NHS as an organisation, Dr John Parry turned that around to say that we need to utilize patients' energy (for becoming involved). That is very true - patients have a strong motivation to improve their situation that could be harnessed to great effect!
  • In an excellent Masterclass on Ethnography (see previous blog post here), Oliver Sweet made several very poignant remarks... "I'm fine" - people need support but that isn't always obvious until you take time to see their routine and lifestyle. Another comment by a patient he picked up was that is was ok for their husband to be ill because they could "afford to be ill" - sadly that is not the case for many many people. 
  • Dr Charles Murray gave an outstanding and inspiring Masterclass on quality of life in relation to IBS - so much to say that a separate post will follow . . . 
  • John Loader opened the afternoon with a video I have included in a previous post (see here) that really grounded the discussions for the afternoon.
  • In relation to the contraversy of a 7-day NHS, Dr Janet Williamson commented that "do doctors and HCP know how valuable they are as a resource and helpline for patients?" I think that if doctors and HCP really grasped how much patients rely on them, their approach to the six-monthly appointments might be slightly better?!
  • During the Question Time at the end, some interesting points were raised by the audience . . . Encouragingly, the panel thought that "clinical effectiveness and financial sustainability can be optimized by addressing patient experience." Also the importance of psycho-social support in relation to survivorship was recognised. One very good point was made that despite "well-being" being in the title of the conference, it was given little focus during the day. I very much agreed - there was a lot of discussion  of technology and clinical outcomes and process and change, but the core of long-term condition management was ignored. Well-being is hard to define (as I mentioned before here), but that does not excuse it! 
I left the conference feeling really excited about some of the work I had heard about, but also with a feeling of concern about technology solutions. So much time was devoted to technological solutions such as tele-health and patient record management systems. I fear that the glamorous corporate backing behind these 'interventions' is being favoured as a simple solution. The reality of installing technology in comparison to talking and supporting patients psychologically is far easier and much more measurable. Both approaches have their merits, but technology is no replacement for the human time, compassion and support that patients with long-term conditions really need.

No comments:

Post a Comment