Key components of self-management support

People need a range of support to enable them to manage their health and wellbeing.  The ‘House of Care’ was originally developed by the Year of Care partnership as a model for diabetes care, but has since been adapted and developed and provides a useful framework for thinking about the full set of interdependent activities and approaches that are needed to effectively support people to self-manage. 



Using the House of Care model, emphasises that self-management support relies on 5 key elements across the local system:

  • Commissioning
    Commissioning is the foundation of self-management support.  Effective commissioning recognizes the social as well as medical aspects of long term conditions.  It holds NHS services to account for working in ways that facilitate people to self-manage, and it ensures that people have access to a range of social interventions to complement their clinical care.
  • People with long  term conditions
    People with long term conditions need the motivation, knowledge, skills and confidence to better manage their own health.  This can be provided through a variety of mechanisms including training in self-management, one-to-one health coaching, peer-support and online tools.  The most common starting point for health economies wanting to support people to self-manage is to provide training that gives people a better understanding of their condition(s) and the knowledge, skills and confidence they need to manage those conditions and the impact they have on their day to day life.
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  • Health professionals, health coaches and others who support people with long term conditions
    Health professionals, health coaches and others who support people with long term conditions need the knowledge and skills for technical tasks, but also the specific skills and approaches which have been shown to be effective in supporting and enabling people to self-manage. 
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  • Organisationnal systems and processes
    Organisational systems and processes need to be embedded with the tools, systems and processes that support people to self-manage (such as providing patients with their test results before their appointment) and that help professionals to support them (such as on-screen prompts to refer people to self-management training). 
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  • Peer support
    Peer support needs to be routinely integrated into the health care system so that people are supported to live well with their condition beyond their appointments with health professionals and services.  It includes interventions such as peer support groups, debt counselling, walking groups, befriending, one-to-one coaching and community cooking classes.  There is a growing body of evidence supporting the benefits of these types of community-based services for people with long-term health conditions.
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All resource on self-management support