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AUG 28/2014

Patient activation pilot: improving treatment of long-term conditions

The NHS is continually aiming to improve the quality of care it provides by developing and experimenting with new approaches to treatment provision. The purpose of doing so is to ensure GP staff and other medical professionals always have the best possible tools, best practice guidelines and resources available to them to do their jobs effectively.

In May, a pilot scheme was launched by NHS England that utilises a new assessment tool known as patient activation to help doctors assess the care and support needs of people with long-term conditions more effectively.

Launched in partnership with the King's Fund, the Health Foundation, five clinical commissioning groups and the Renal Registry, the trial programme could potentially bring significant benefits to patients across the country if it proves a success.

The benefits of patient activation
As described by the King's Fund in a report issued last month, patient activation is a way of measuring how engaged people are with improving their own health. Using an evaluation tool called the Patient Activation Measure (PAM), medical professionals are able to assess how likely an individual patient is to be proactive about eliminating their own detrimental health behaviours.

The PAM measures an individual's knowledge, skill and confidence for health self-management.  People who are more activated are significantly more likely to attend screenings, check-ups and immunisations, as well as being more inclined to adopt positive behaviours and have clinical indicators in the normal range.

Meanwhile, those who are less activated are less likely to prepare questions for a medical visit, know about treatment guidelines or be persistent in clarifying advice. As such, this metric is thought to be a better predictor of health outcomes than known socio-demographic factors, such as ethnicity and age.

Indeed, research has shown that less-activated patients have care costs approximately eight per cent higher than more-activated patients in the baseline year and 21 per cent higher in the subsequent year. As such, appropriately-designed interventions that can increase activation levels can bring considerable health benefits.

How the new pilot scheme will help
The new NHS England pilot will cover 150,000 people and will focus on giving healthcare professionals the opportunity to work with the ten per cent of patients who have low levels of activation, helping them become more engaged with their own care and highlighting where they need extra support.

Dr Martin McShane, NHS England's director for long-term conditions, said: "I wish I had known about patient activation 30 years ago ... It's about understanding that when talking to patients that there are two experts in the room - one with individual experience, the other with medical expertise. This pilot will bring together the best of both."

Meanwhile, Adrian Sieff, assistant director of strategy at the Health Foundation, said: "Patient activation can work as both a core diagnostic tool and an intermediate outcome measure."

At a time when the NHS is placing an increased focus on the proactive treatment of long-term conditions - and moving towards community-oriented preventative care models, rather than hospital-centric emergency treatment - tools such as patient activation could become increasingly invaluable.

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