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Person Centred Approaches to Long Term Condition Management

Discussion in 'Lifestyle Management' started by Keela Too, Sep 2, 2018.

  1. Keela Too

    Keela Too Senior Member (Voting Rights)

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    This came up on Twitter, and although it mostly relates to diabetes, I thought a process like this could perhaps be useful for ME patients.



    PROVIDED - OF COURSE - THE CARE WAS NOT BASED ON PACE-STYLE CBT/GET!

    http://coalitionforcollaborativecar...ng-term-condition-management-in-primary-care/

    If this sort of process was used, it could help highlight patients who have less family support, or more difficult circumstances, and so help to direct appropriate additional support towards those who are most in need.

    I guess it’s too soon to look at something like this before the basic premise of standard ME care is sorted out (ie We have good care in place that is NOT based on deconditioning hypothesis, or the concept of sensitisation or whatever notion the BPS cabal foist in our direction next!)

    However, for the future, sympathetically applied, something like this might be more constructive than MUS and IAPT.

    Just a thought..

    Any diabetics here know anything more on this? Does it work as it seems it should?
     
    Keela Too, Sep 2, 2018
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  2. Trish

    Trish Moderator Staff Member

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    My response is - I hate jargon.

    Why do they have to make it sound so complicated. Surely all the stuff described is just what a good diabetes specialist nurse should be doing anyway at the patients' regular checkups. Not only assessing how well the patients are managing their symptoms and treatment, but how well they are coping and whether more support is needed, either from the doctor, the nurse, a dietician or possibly a social worker or some other professional to help with difficult home circumstances.

    Edit to add: if I had a letter from my GP practice congratulating me for doing so well I'd see it as patronising and a waste of resources. But then I'm a grumpy old woman.
     
    Trish, Sep 2, 2018
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  3. Keela Too

    Keela Too Senior Member (Voting Rights)

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    Agree, to some degree @Trish

    However, if a “process” is required to replace the IAPT & MUS processes, then I’d rather support something like this. ;)
     
    Keela Too, Sep 2, 2018
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  4. Trish

    Trish Moderator Staff Member

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    Trish, Sep 2, 2018
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  5. Invisible Woman

    Invisible Woman Senior Member (Voting Rights)

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    My niece is in her mid 20's and was diagnosed with Type 1 diabetes when she was a toddler.

    She is a very active person with a busy lifestyle and would love an insulin pump. The NHS won't supply one because she manages her condition too well. She can't afford one - the pump itself is over £1k and then the thingies (cartridges?) are really expensive too and they won't fund that either (even though they would save on her usual supplies).

    In short she controls her illness reasonably well. There's a device which would help her do it better and that could probably save the NHS money in the long term and they won't even let her pay the difference in cost, let alone fund it.

    I think there's a good chance she'd tell them to naff off.

    Edit -spelling
     
    Last edited: Sep 2, 2018
    Invisible Woman, Sep 2, 2018
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  6. Sean

    Sean Senior Member (Voting Rights)

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    To justify their 'expertise', and hence their income and authority.
     
    Sean, Sep 3, 2018
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  7. Keela Too

    Keela Too Senior Member (Voting Rights)

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    In some ways it’s a simplification. Each patient gets one of four management options. Part of which might be managed by the secretaries behind the system (referring to others etc).

    AND if it could counter the slick MUS/IAPT machines then, honestly, I’d not object to jargon.

    If the letter also gave pointers to watch out for, and the advice to recontact them if the patient had further concerns, then it would not sound so condescending.

    Anyway, I thought the idea of interest, as it really does seem to look at getting the best for each patient, whilst being mindful of resources.

    Having said that, I’m sure our psych brigade could mash it to their needs pretty quick. :(
     
    Keela Too, Sep 3, 2018
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  8. Trish

    Trish Moderator Staff Member

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    You're right, it is of interest, sorry to have been so grumpy about it.

    I think it reflects the way large scale medical care has to be so structured with lists and tick boxes and categories. In a smaller scale situation like the old fashioned GP and district nurse working together they would have automatically done this sort of recognition of different patients needs for different levels and types of intervention.

    I think the need for something like the structure described here probably partly arises because GP's are working in larger group practices, and patients don't necessarily see the same doctor and nurse every time, so everything has to be recorded in a much more systematic way.
     
    Trish, Sep 3, 2018
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  9. Keela Too

    Keela Too Senior Member (Voting Rights)

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    I’ve tweeted the author, just to see if he expresses any opinion on MUS & IAPT

     
    Keela Too, Sep 3, 2018
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