Toby* was struggling to manage his latest episode of acute mental ill health. The desire was there – he knew he wanted to put support measures in place to avert a crisis. And he wanted to start a training programme that could help improve his computer skills. But he was falling at the first hurdle: getting in touch with the mental health support worker - Steve - who had first told him about these opportunities.

Toby booked a GP appointment just so that he could ask his doctor to find Steve’s contact number in the care and support plan he had been given. This plan was supposedly a person-centred document, but in practice it was more focused on the overall system than the system users. It collected all the possible contacts into one impenetrable pack which Toby was unable to use. Not only did it fail to help Toby, it forced him to use further NHS resources.

Today sees the launch of two guides which could help the health and care system take a new approach. The guides are written by The Behavioural Insights Team (BIT) following 18 months of learning from five person- and community-centred organisations, expert patients, switched-on practitioners and champion commissioners. The guides were written as part of the Realising the Value programme, which seeks to identify evidence-based approaches that engage people in their own health and care and develop the tools to support implementation.

In contrast to Toby’s experience, our guide Supporting self-management suggests making simple ‘if-then’ plans which are created by the person themselves using a memorable formula e.g. If I experience a worsening of my condition, then I will call Steve’s number, which he saved in my phone the first time we met. This approach recognises the value both of the patient and the supportive community he has relationships with.

Other insights from Supporting self-management are summarised below. In order to promote self-management organisations should make their activities easy, attractive, social and timely:

Pockets of great practice exist - and the guides collect many inspiring examples together. Yet the question that follows for policymakers and commissioners tends to be, “how do we spread this throughout the health and care system?” The second guide  –  Spreading change  –  holds some answers. We provide examples where champions within the system do the following:

In order to encourage person- and community-centred approaches to spread from a community base, organisations in turn can do the following:

In order to spark action, Spreading change links to tested tools, which have been used in other settings to change professional mindsets. Teachers using these tools start to train students who see challenges as learning opportunities. Students’ academic attainment inches up when teachers believe that students are capable of growing their potential and overcoming obstacles. These tools hold promise for changing the mindsets of health professionals too; the translation into realising the value of patients to self-manage is not hard to see.

Many of the individual activities listed in the guides sound like no-brainers: they are simple. And yet, our observations as part of the programme suggest they cannot be taken for granted. Both guides conclude that the tools they cite should be tried and tested throughout the health and care system. This is the way we will learn more about ‘what works’, in a particular setting and how they can be adapted to increase these tools’ efficacy further.

These guides therefore have a simple mission: connecting people to ideas and tools that are easy to incorporate into existing practice. Keeping changes small in the first instance will not only make it more likely that movement will start, it will also pay dividends across millions of contacts with the health, care and community systems.

*This describes a real encounter, although names have been changed to protect patient confidentiality.