出版社：Utrecht University, Maastricht University, Groningen University
摘要：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. References : 1- Smith et al. Taking care of our health and social care in greater Manchester. http://www.gmhsc.org.uk/delivering-the-plan/ [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: https://www.nesta.org.uk/sites/default/files/realising-the-value-ten-key-actions-to-put-people-and-communities-at-the-heart-of-health-and-wellbeing_0.pdf [Accessed 20th July 2017]
关键词：integration ; population based health ; community ; assets ; health promotion
