Quality statement 3: Self‑management

Quality statement

Adults with osteoarthritis participate in developing a self‑management plan that directs them to any support they may need.

Rationale

Providing a framework that encourages and supports self‑management is an important tool to support shared decision making and ensure that people are at the centre of their care. Self‑management principles empower the person by enhancing their understanding and knowledge of osteoarthritis and its management, and by enabling them to identify their own priorities and goals for their treatment. This may include developing skills such as problem solving, goal setting, coping strategies and managing relationships. They can then use this knowledge and their skills to access resources and build on their own experiences of managing their osteoarthritis. Self‑management can improve patient experience and health outcomes, as well as increasing adherence with the treatment plan and reducing reliance on healthcare interventions.

Quality measures

Structure

Evidence of local arrangements to ensure that adults with osteoarthritis participate in developing a self‑management plan that directs them to any support they may need.

Data source: Local data collection.

Process

a) Proportion of adults with osteoarthritis with a record of having received written information about osteoarthritis and its management.

Numerator – the number in the denominator with a record of having received written information about osteoarthritis and its management.

Denominator – the number of adults newly diagnosed with osteoarthritis.

Data source: Local data collection. Data on the provision of information about osteoarthritis are included in the Keele Primary Care Consortium Osteoarthritis (OA) e-template for primary care consultations (endorsed by NICE).

b) Proportion of adults diagnosed with osteoarthritis who participate in developing a self‑management plan.

Numerator – the number in the denominator who participate in developing a self‑management plan.

Denominator – the number of adults newly diagnosed with osteoarthritis.

Data source: Local data collection. Data on self‑management plans are included in the 'care.data' extract for the Health and Social Care Information Centre (not specific to people with osteoarthritis).

c) Proportion of adults with osteoarthritis who participate in reviewing a self‑management plan.

Numerator – the number in the denominator who participate in reviewing a self‑management plan.

Denominator – the number of adults with osteoarthritis attending for a scheduled review of their care.

Data source: Local data collection.

Outcome

Adults with osteoarthritis are satisfied that they have the knowledge and confidence they need to self‑manage their condition.

Data source: Local data collection.

What the quality statement means for service providers, healthcare professionals and commissioners

Service providers (GPs and community healthcare providers) ensure that processes are in place so that adults with osteoarthritis participate in developing a self‑management plan that directs them to any support they may need. Service providers should also agree local referral pathways that may include support provided by voluntary sector organisations.

Healthcare professionals work with adults with osteoarthritis to develop an individual self‑management plan that gives the person information and advice and directs them to any support they may need to help them manage their condition.

Commissioners (such as clinical commissioning groups and NHS England) ensure that they commission services in which adults with osteoarthritis participate in developing a self‑management plan that directs them to any support they made need, and which have local arrangements in place to ensure that support is available, including services provided by the voluntary sector. Commissioners should request monitoring data and consider an audit of community healthcare providers to check that self‑management plans are in place for all adults with osteoarthritis. Commissioners should also ensure that community care providers have sufficient capacity to offer specialised support if needed, including from physiotherapists, occupational therapists, dietitians and podiatrists.

What the quality statement means for patients, service users and carers

Adults with osteoarthritis agree a self‑management plan with their GP or nurse that covers what they can do to help manage their condition, including improving their symptoms and quality of life. The plan should identify where they can get the support they may need to help them do this.

Source guidance

  • Osteoarthritis (2014) NICE guideline CG177, recommendations 1.2.5, 1.3.1, 1.3.2 (key priorities for implementation), 1.2.2 and 1.3.3

Definitions of terms used in this quality statement

Self‑management plan

A self‑management plan is jointly developed with the person with osteoarthritis and should be provided in verbal and written formats. It can include:

  • a record of the agreed approach to self‑managing the condition, including individual goals

  • information and advice about the condition and its treatment, including how to find support groups and online information sources

  • advice and support to increase physical activity and exercise, including pacing strategies, that gives information about local services such as physiotherapy, or exercise classes, groups and facilities

  • advice and support for people who are overweight or obese to lose weight, which may include referral to local resources such as weight‑loss and exercise programmes

  • details of self‑management programmes available locally on an individual or group basis

  • referral to local services such as occupational therapy, orthotics and podiatry that can provide advice on suitable footwear, orthotic devices (such as insoles and braces) and assistive devices (such as walking sticks and tap turners)

  • pain management advice

  • medicines management advice, including who can provide support (for example, community pharmacies)

  • when to have a review of their osteoarthritis.

[Adapted from Osteoarthritis (NICE guideline CG177) recommendations 1.3.1, 1.3.2, 1.4.1 (key priorities for implementation), 1.2.2, 1.3.3, 1.4.3, 1.4.7, 1.4.8, 1.4.9 and 1.7.1]

Equality and diversity considerations

Healthcare professionals should take into account cultural and communication needs (including any learning disabilities) when providing information and support for adults with osteoarthritis. This should include providing printed information for people who cannot access information online and providing information in accessible large print and easy read formats where required.

Not all people will want to self‑manage osteoarthritis or be able to do so, and healthcare professionals should identify any vulnerable people who may need additional support.