The NHS needs to develop an integrated approach to self-care if expert patient programmes are to deliver significant economic benefits to the NHS, a study has concluded.
A literature review and questionnaire run by the Expert Patients Programme Community Interest Company says a self-management pathway for patients should be developed, with better identification of and case management for participants and improved training for clinicians.
Otherwise, it suggests that EPPs will continue attract informed patients who are already active self-managers and who have limited scope for improvement; missing those with the poorest health outcomes who potentially have most to gain.
The study claims that cost savings of around £1,800 per person per year should be achievable if EPPs are targeted at people with the poorest health outcomes as part of a structure care pathway, with the savings coming from lower use of services and less reliance on medication. The average cost of EPPs at the moment is £400.
The study says telephone support should be part of the support package. However, it ignores IT as a way of identifying or supporting patients, focusing instead on traditional consultations and courses.
The NHS Expert Patients Programme was piloted and then mainstreamed between 2001 and 2007. The new study looked at existing academic papers and found they tended to focus on benefits to patients, rather than reduced healthcare usage.
It then sent a questionnaire to 1,000 people who had attended EPP courses over 12 months and asked them if they had reduced their use of NHS services or the medication they use. More than 50% said they had reduced their use of A&E and GP services and 35% the medication they use.
In depth interviews were used to develop recommendations on an creating an integrated approach to self-care and developing a model self-care pathway.