People helping people to stay well
There's lots of interesting material in the reports that my colleagues have published today following Nesta's People Powered Health programme, not least the finding that we already know how to save 7% of clinical commissioning budgets. For me it's become a little more personal.
These are the diseases that medicine can't cure – diabetes, lung disease, poor mental health, hyper tension and heart disease, and many more less well known conditions.
Just over a year ago I found out that I had developed a rare disease of the immune system. It affects my lungs, makes breathing hard and feels a lot like a permanent bout of flu. There's no logic to it. No-one really understands where it comes from. All I know is that it has become a fact in my life.
Like all long term health conditions it can't be cured. The different drugs I've been given have been amazing and I am in awe of scientific discoveries that mean that I can carry on a largely normal life. Before the discovery of steroids my prognosis would have been dire.
Just as important as the drugs has been my family and the networks that provide me with emotional support, the online patient groups where I can talk to people dealing with the same side effects from the drugs, an understanding employer and the "friends" who cajole me into taking the exercise that makes all the difference.
In many ways it's been an odd experience, learning about the issues through direct personal experience while trying to understand them objectively at work. It perhaps explains why I've become so passionate about the potential for networked and mutual approaches to care to be a much bigger part of how we help people live with long term health conditions.
I'm fortunate in having a condition that hasn't been too debilitating and benefiting from relative youth, strong networks and access to knowledge about what I need to do. Not everyone is so fortunate.
If there is a critique to be made of the healthcare system bequeathed to us by our great-grandparents it's that it does things to people. Patients go to the health service to be made well and all too often they are seen – and behave – as passive recipients of care.
It doesn't pay enough attention to the context in which people live and hasn't managed to mobilise people's families, communities and networks.
We know that diet, exercise and lifestyle matter enormously and demand that patients are active partners in creating their own health. We've also learnt about the importance of families, peers and social networks in helping people make the positive changes that lead them to live better lives and reduce the demands on an already over-stretched system.
This isn't new knowledge. Over the past year I've been in dozens of debates with health professionals and academics who know that we have to develop a health system that harnesses the capabilities and commitment of citizens to help each other: people helping people.
What's been lacking is the rigour of thinking around how to do it effectively, the evidence of impact for specific interventions and the interactions with the health systems that will make the People Powered Health approach more normal.
Innovations like peer support groups, social prescribing and group consultations aren't new to the world, but we are only just starting to formalise our understanding of how they work and figure out how to spread them across the system.
As I've learnt through my own experience, mobilising your family and social networks to help you, engaging with people who share your experience and figuring out what you can do to take control of your health are vital.
The vision for People Powered Health is of a system that is better able to mobilise that kind of support for everyone living with a long term health condition.
@philipcolligan is Executive Director of Nesta's Public Services Lab and an Adviser to the Government on Social Innovation.