Over the past year I have been working with a number of organisations to think through how the NHS can achieve much better outcomes by encouraging patients take on much greater self management of their long term conditions. Whilst few people in the NHS would ever say that they are against self management as a form of care, it has failed to become part of the central activity of the NHS and remains on the periphery.

Over the last year I have occasionally posted about this issue bringing reactions from some commentators that usually runs along the lines of – “It’s all right for articulate middle class patients, but if you saw the people who come to see me they could never self manage their illness because they don’t have the capacity.” – Their argument is that some patients demand dependency and aren’t be able to take charge of their own condition or health.