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System wide self care


Kirsty Marshall ,

Tameside and Glossop Integrated Care NHS Foundation Trust, GB
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Chris Easton

Tameside and Glossop Integrated Care NHS Foundation Trust, GB
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Introduction: Greater Manchester despite having a vibrant economy, has a higher than average prevalence of long term conditions, the impact being that people require support from health care services at a much younger age and for much greater periods of time1 . In 2016, a £6 billion health and social care budget was devolved to the region, with the ambition of radically improving the health outcomes, through the upscaling of prevention, early intervention, and self-care services. Devolution aims to facilitate happier, healthier and more prosperous communities. Supported by a sustainable health and social care economy1

Description of policy: To meet this ambition locally, the newly formed integrated care organisation developed a system wide self-care policy. The policy promotes working harmoniously with local communities to: tackle inequalities caused by the social determinants of health, change relationships between care providers and the wider population, and encourages the adoption of positive health behaviours.

Ultimately, the policy facilitates a transformational shift from mainly treating ill health to proactively preventing and managing health and wellbeing3. This required fostering a ‘social model of health’ that combines a deep understanding of what matters to people, with excellent clinical care, timely data, and strong, sustained social support2. The policy was co-produced with a range of partners, including the voluntary/community sector.

Asset based approaches to health care delivery are also key to the approach and the whole programme is under pinned by a workforce development programme across all sectors of the integrated organisation.

Targeted population: System wide self-care is a population wide approach, with a focus on improving the health of the most vulnerable within our community, frail elderly, children and young people, mental health care and people with complex co-morbidity.

Highlights (innovation, Impact and outcomes)

Development of a collaborative approach across the health and social care economy

Launch of social prescribing within first neighbourhood

Commissioning of a third sector social prescribing team

Commissioning of a comprehensive asset based community development programme

Completion of workforce training pilot

GP engagement

Section as part of the GM transformation fund

Comments on transferability: The policy provides a framework for a whole system. Providing guidance and vision alongside practical application of a wide range of interventions, which, can be tailored to local need. Early evaluation has demonstrated that local neighbourhood teams are able match the interventions to need of their population.

Conclusions: The innovation within this policy is that it draws together several tried and tested self-care approaches within a framework that can be applied across whole health and social care economies. Acknowledging that current health and health social issues rarely require a single silo solutions.


1- Smith et al. Taking care of our health and social care in greater Manchester. [Accessed September 1st 2017]

2- Foot J & Hopkins T. (A glass half-full: how an asset approach can improve community health and wellbeing. London: Improvement and Development Agency (IDeA). 2010

3- Nesta. Realising the value. Available from: [Accessed 20th July 2017]


How to Cite: Marshall K, Easton C. System wide self care. International Journal of Integrated Care. 2018;18(s2):26. DOI:
Published on 23 Oct 2018.


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