PATIENT SKILLS
DEVELOPMENT
PROGRAMME
Guide for Facilitators
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1
About this Guide
This Guidance is written for people who are facilitating a Patient Skills Programme. It
provides
 an overview of the programme
 an overview of the modules
 a standard programme for six sessions
 guidance on creating new activities
It is supported by a series of separate more detailed guides:
 guide to facilitator training, skills and assessment
 guide to quality assurance
 3 Facilitator Manuals each covering the activities for the relevant module (see below)
 guide for programme leads
 participant Workbook and Handouts
All of the guides and further information about self management and self management
support are available on our Resource Centre at http://www.health.org.uk/resourcecentre/new-sms/. The Resource Centre also includes a wide range of resources that can be
given to people with long term conditions to help them self manage and a wide range of
resources to help those running Patient Skills Programmes.
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2
Overview of the programme
2.1
The purpose of the Patient Skills Programme
The core focus of the programme is to enable people to better manage their own health,
through increasing their self confidence, increasing their skills and supporting positive
changes in health related behaviour, leading to activated patients who feel in control of their
health choices.
2.2
How this programme relates to wider health services
The Patient Skills Programme does not, and should not, exist in isolation from the wider
health services that people use. The Health Foundation, through its Co-Creating Health
programme, believes that people with long term conditions are best able to manage their
own condition when:
 they have the necessary skills, knowledge and confidence
 they are being supported by clinicians proactively using self management support skills
and techniques
 the systems and processes of the healthcare service are designed to support self
management
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2.3
Course structure
The Patient Skills Programme is normally run over six weeks, with a workshop a week. Each
workshop consists of a series of activities, each lasting 20 minutes, which are put together to
create a single session lasting 2 hours 40 minutes.
However, the programme is designed to be adaptable, and may, for example, be spread over
longer by running (particularly the last two or three sessions) at fortnightly, rather than
weekly, intervals, or by creating new workshops.
2.4
Course delivery: co-facilitation
What makes the programme unique is that it is co-delivered by a health professional and a
person with experience of living with a long term condition working in partnership. This
collaboration between the professional and lay tutors is a model for the collaborative
relationship the programme is promoting between health professionals and patients.
Feedback from previous participants has shown that they find the different perspectives,
experience, knowledge and skills that the tutors from different backgrounds bring extremely
valuable.
2.5
Course content
The programme is made up of three sets (Modules) of activities, containing a range of
different components and activities:
 Module A: Core Repeated Activities: Goal-setting, Goal Follow-up and Problem solving
– These activities are core to health related behaviour change and should be included
and repeated in every workshop.
 Module B: Core Generic Self-management skills
– These activities are also considered core self management activities or core to the
group process. Each activity should be covered at least once in the course of Patient
Skills Programme.
 Module C: Optional Self-management skills and topics
– These activities are optional and may be included as needed. Additional module 3
activities may be created for specific diseases and communities.
Each week (other than week one) comprises a mix of activities, some of which are core to
the process and some which may be substituted, and one optional module chosen within the
group through shared agenda setting. This space may also be used for discussion or repeat
of previous activities if needed. However it is important that activities from Module A are
always included in each week.
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Over the course of the programme participants are able to develop and practice core skills
learnt on the programme.
3
The modules
As described above, each week (other than week one) comprises a mix of activities:
 activities in Module A are core to the process and should be repeated each week
 activities in Module B are core and need to be covered at least once over the course of
the 6 sessions
 activities in Module C are optional and may or may not be covered according to the
needs of the group.
Programmes may be generic (i.e. open to people with any long-term condition) or disease
specific (i.e. only open to people with a specific long-term condition). Many patients will have
similar needs in terms of self management support regardless of their condition.
Whichever type of programme you are running, you must cover all the activities in Modules A
and B, but the optional activities in Module C can be used according to their relevance and
usefulness to the particular group or condition you are working with.
MODULE A: CORE REPEATED ACTIVITIES
These activities are core to health related behaviour change and should be
included and repeated in every workshop.
A1 Goal-setting
A2 Setting the Agenda and Close
A3 Follow-up
A4 Sharing and agreeing an Agenda
A5 Working on a Self-management Goal
A6 Problem-solving
A7 Weekly Goal Setting
A8 Setting Longer term goals
MODULE B: CORE GENERIC SKILLS
These activities are also considered core self management activities. Each
activity should be covered at least once in the course of Patient Skills
Programme.
B1
Getting to Know One another
B2
Understanding Self-management
B3
Recognising and accepting Change
B4
Challenging Unhelpful Beliefs
B5
Working together in Partnership
B6
What happens next? Follow-up options
B7
Anxiety, relaxation and your health condition
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B8
B9
B10
B11
Planning
Communicating our needs and feelings
Becoming a Resourceful Self-manager
Recognising and Managing Setbacks
MODULE C: OPTIONAL SKILLS AND TOPICS
These activities are optional and may be included as needed. Additional
module 3 activities may be created for specific diseases and communities.
C1
Helpful Breathing
C2
Eating well
C3
Managing fatigue, helpful rest and sleep
C4
Being thankful for what’s going well
C5
Becoming more active
C6
Dealing with emotional impact
C7
Using our minds as a Self-management Tool
C8
Making and sharing plans for future healthcare
C9
Making a self-care plan in partnership
C10 Accepting and asking for help and support from others
Each of the modules is set out in a manual, which contains all the activities for that module.
Module C contains a library of optional activities which may be generic or condition-specific.
There is time allocated in each workshop, with the exception of Workshop 1, for one or two of
these activities to be included. At the end of workshops 1-5 there is an opportunity for the
participants and facilitators to negotiate the agenda for the next workshop. Further conditionspecific activities may be developed by individual organisations delivering the programme.
These can be added to the Module Three library.
This list of the Module Three options and a brief description can be used by facilitators to
help them during this Agenda-setting process.
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Module C Options
Activity Name
Fatigue, rest and sleep
Activity Description
Helps us to recognise and identify ways that fatigue can be
managed by effective planning, rest, relaxation and sleep.
Eating well-making
choices, making changes
Allows us to identify some small changes in the food and drink
choices we make and to consider and find solutions to the
barriers to making these changes.
Helpful breathing
Introduces and practices helpful breathing and explains how it
may help to regain control of symptoms and reduce anxiety.
Mixed feelings about
Explore our own ideas about the importance and benefits to us
being active
of becoming more active and allows us to consider our own
mixed feelings about it.
Acknowledging and
Recognises and acknowledges that negative emotions (fear,
managing unhelpful
anxiety, worry, and guilt) frequently accompany a health
emotions
condition, reflects on your experience and to consider ways
that these emotions can be handled positively.
Making a self-care plan in Introduce the Care-planning process which can be done with a
partnership
member of the health care team and considers how it is being
introduced locally.
NB check local relevance.
Making and sharing plans Considers the subject of planning for future, when we may be
for future health care
more unwell and unable to make our own decisions, and how
to communicate these plans with family, friends and the health
care team.
Using our minds as a
Introduce the concept of the mind as a self-management tool,
self-management tool
the mind body connection and some helpful techniques to
manage symptoms leading to more optimal self-management.
Being Thankful for what’s Enables us to feel less anxious and more relaxed by allowing
going well
us the opportunity to show gratitude for, and share with others
simple events and experiences which have made us feel
good.
Accepting and asking for Explores reasons why asking for help can be difficult and
help and support from
considers ways to access varying types of support from family,
others
friends and colleagues.
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4
Standard programme
All the modules are designed to be delivered flexibly, in the order and at the pace that best
suits the group, however, we have set out below a standard programme for each of the six
workshops.
Programme for workshop 1
Module
Activity
B
B
B
A
A
B1
B2
B3
A1
A2
Getting to know one another
Understanding self-management
Recognising and accepting change
Introducing goal-setting
Setting the agenda and close
Programme for workshop 2
Module
Activity
A
B
C
A
A
A
A3
B4
C1
A4
A5
A2
Welcome
Follow-up
Challenging unhelpful beliefs
Helpful breathing (optional)
Sharing and agreeing agenda
Working on a self-management goal
Setting the agenda and Close
Programme for workshop 3
Module
Activity
A
B
A
C
A
A
A3
B5
A6
C2
A7
A2
Guide for Facilitators
Welcome
Follow-up
Working together in partnership
Problem-solving
Eating Well (optional)
Weekly goal setting
Setting the agenda and close
Time
(minutes)
40
20
20
40
Time
(minutes)
5
30
20
20
20
30
10
Time
(minutes)
30
20
20
20
30
10
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Programme for workshop 4
Module
Activity
A
B
B
C
A
A
A3
B6
B7
C3
A7
A2
Welcome
Follow-up
What happens next? Follow-up options
Anxiety, relaxation and your health condition
Managing fatigue, helpful rest and sleep(optional)
Weekly goal setting
Setting the agenda and close
Programme for workshop 5
Module
Activity
A
B
B
C
A
A
A3
B8
B9
C4
A7
A2
Welcome
Follow-up
Planning
Communicating our needs and feelings
Being thankful for what’s going well (optional)
Weekly goal setting
Setting the agenda and close
Programme for workshop 6
Module
Activity
A
B
B
C
A3
B10
B11
C10
A
A8
Guide for Facilitators
Welcome
Follow-up
Becoming a resourceful self-manager
Recognising and managing set-backs
Accepting and asking for support from others
(optional)
Setting Longer term goals
Close and evaluation
Time
(minutes)
30
20
20
20
30
10
Time
(minutes)
30
20
20
20
30
10
Time
(minutes)
30
20
20
20
30
10
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5
Creating new activities
5.1
Types of activity you might wish to create
The programme has been designed to cover all the activities set out, but you may find that
you wish to create additional activities, these might, for example, be:
 activities to address disease specific issues
 activities it increase knowledge/provide information
 activities to focus on specific health behaviours and attitudes
5.2
Questions to help you decide whether a new activity is needed
When deciding whether to develop new activities, you should consider:
 How was the need for the activities identified?
 What is the objective of the activities?
 What outcome do you wish to achieve with the activity?
 How will you evidence its effect?
5.3
Top tips for designing new activities
 Keep it simple and to the point – avoid becoming too wordy.
 Limit the medical information - The aim of self management is to enable changes in
behaviour, attitudes. Some information is important but should be limited to what is need
to make a informed choice- e.g. what food to eat etc – so avoid making it too medical.
 Keep activities to 20 minutes - that’s long enough for people who have been out of
work or a learning environment for a long time.
 Avoid making it too complicated – you want the programme to be as easy to
understand as possible, many people have low literacy and health literacy, or are simply
not used to working with lots of complexity.
 Make it interactive – avoid lectures.
 Avoid advising or telling people what to do.
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For further information:
Tel: 0207 257 800
www.health.org.uk
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