By Professor Nick Francis, Head of School of Primary Care, Population Sciences and Medical Education

Our beloved NHS is creaking at the seams. Many parts of the service are still providing a high-quality service but access to services is challenged in just about every area. While there are no easy solutions, and chronic under-investment is a major factor, the ever-growing demand for healthcare is creating challenges for many health services around the globe. Many people seeking healthcare will benefit from the expertise, technology and resources provided by the healthcare system. However, no healthcare system can, nor should, manage all the health needs experienced by a population. High-quality, evidence-based supported self-management not only helps manage demand so that our healthcare system is able to meet the demands of those who need healthcare, it can also offer huge advantages for patients.

Professor Nick Francis

Supported self-management is important for both acute and long-term conditions, as well as in managing risk factors and preventing disease. Behavioural interventions can help people gain the knowledge, skills and confidence to adopt healthy lifestyles, optimally use prescribed and over-the-counter treatments and appropriately access healthcare. Self-management is a crucial part of remaining healthy and, while many healthcare professionals are good at supporting self-management, to do so at scale we need to develop tools that are not dependent on substantial amounts of healthcare professional time.

Supporting self-management might sound simple, but if not careful, efforts to increase self-management can have detrimental effects, including widening health inequalities. Tools to support self-management need to be developed with patients and members of the public from diverse backgrounds, and using the latest evidence, theories, and approaches.

The University of Southampton is an international leader in developing and evaluating behaviour change interventions to support self-management. Bringing together patients, clinicians and expertise from health psychology and applied healthcare evaluation (statistics, clinical trials, health economics) researchers have developed digital tools that have been proven to improve health outcomes for a range of conditions including weight loss, irritable bowel syndrome, eczema, asthma, back pain and cognitive impairment. Digital interventions have many benefits, including scalability and ease of access, but self-management interventions are also delivered in person and our research teams are conducting research to improve healthcare communication and demonstrate the importance of empathy and optimism when discussing self-management with patients.

Smartphone and wearable technologies are developing at a rapid pace, and we are exploring opportunities for utilising these devices to improve self-management. For example, we currently have a collaborative project with acoustic engineers and AI computer scientists that aims to harness the power of the smartphone to use recorded sounds (breathing, coughing, speaking) to predict whether a respiratory tract infection is likely to get better or worse. Combining the power of AI technologies with insights from health psychology and sociology is likely to become increasingly important.

These tools are not going to ‘save the NHS’ singlehandedly, but with an expanding, ageing population there is no doubt that supporting self-management is a key way to improve health outcomes without increasing health service costs, and the University of Southampton continues to play a leading role in delivering on this agenda.

Supporting Self-Management

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