BMJ Open. 2016 Jul 15;6(7):e010853.
- Based on nine CCGs from the south of England, this research examines how self management support is delivered, from plans and aspirations to translation into commissioned services.
- The research was based on content analysis of CCG forward plans for mention of self management support, semistructured interviews with commissioners (n=10) and observations of governing body meetings.
- Despite the rhetoric of ensuring services are designed around patients' needs, the research found that patients and the public were not engaged in commissioning in meaningful ways and their voice was, almost entirely, absent.
- This study highlights where CCG aspirations and operationalisation do not align, and draws attention to where intentions are not being put into practice—effective self management support which is developed from the bottom-up.
- The research notes tensions between national NHS England guidance and local aspirations. While commissioners say that self management support is a priority, details of local initiatives were notably absent with austerity (cost-containment) and nationally measured biomedical outcomes taking precedence.
