Primary care professionals have contributed a lot in recent years to meeting the medical needs of those with diabetes and other chronic illnesses. However, despite being viewed by commentators as the big hope for progressing patient education and self-management support our most recent paper suggests otherwise. We might need to think again whether it’s a good thing to use GPs and practice nurses more in this area.
Our research undertaken with *Greater Manchester CLAHRC shows that in terms of ‘work force’ that non-health professionals provide more valuable support to people’s self-management than primary health care professionals.
Partners and spouses provided most support in terms the amount and intensity of illness, emotional and every-day work whilst most support provided in primary care professional input is work related to illness specific management (medication etc.). The provision of emotional support in Primary care is lower than that obtained from other network members (family, spouses, friends, groups and pets)
The intensity of support was also found to be less than that received from other social network members. Primary care professionals can be described as providing essential but ‘minimally provided support’. This reinforces limited expectations and value about what primary care professionals can provide in terms of support for long-term condition management. That needs to be taken into consideration in looking at how we might look outside professionally dominated networks to think more imaginatively about exploring how extended self-care support could be enhanced out-with primary care.
A lot of unrecognised, imaginative and effective work is undertaken by the lay work force regarding long term condition management. Unlike the professional workforce it seems to operate with a positive care law – expanding and reacting to the changing needs of people.
So thinking about building, valuing and engaging a network to mobilise resources for self-management support. We should look to open settings and the broader community rather than assuming that more has to be done by professional health care workers.
Anne Rogers is Professor of Health Systems Implementation and Research Director CLAHRC Wessex at University of Southampton.
*Collaboration for Leadership in Applied Health Research and Care (Wessex) or CLAHRC Wessex is one of a network of research organisations supported and funded by the National Institute for Health Research which is the research arm of the NHS.