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Education Programmes for Patients

Definition

The EPP (Education Programmes for Patients) was formally known as the Expert Patient Programme.

EPP is a self-management programme for people who are living with a chronic (long-term) condition. The aim is to support people who have a chronic condition by:

  • increasing their confidence
  • improving their quality of life
  • helping them manage their condition more effectively

What is a chronic condition?

Chronic health conditions are conditions that can be controlled but not cured. Living with a chronic condition can have a significant impact on a person's quality of life, as well as on their family and carers.

Common chronic conditions include the following.

  • arthritis: a painful condition that affects the joints and bones
  • asthma: a condition that causes inflammation (swelling) in the airways of the lungs
  • diabetes: a condition that is caused by too much glucose in the blood
  • epilepsy: a condition that causes repeated fits (seizures)
  • heart disease: when the heart's blood supply is blocked or interrupted
  • multiple sclerosis: a condition of the central nervous system (the brain and spinal cord)

Wales has the highest rates of long-term limiting illness in the UK.  This is expected to increase as the population ages, and if people continue to make unhealthy lifestyle choices.  This also accounts for a large proportion of unnecessary emergency admissions to hospital in Wales.

The EPP

EPP Cymru is an NHS initiative which first started in Wales in 2002 when a pilot project was run by two Local Health Boards, Gwynedd and Swansea.

The Welsh Government has shown commitment to the programme and EPP Cymru courses have been rolled out all across Wales

To date:

  • 744 EPP Cymru courses have been delivered in Wales
  • 6,107 people have completed an EPP Cymru course
  • 130 volunteer tutors have been trained
  • 15 local EPP Co-ordinators/Trainers have been employed to help support the volunteers and to manage and arrange the courses locally 

EPP Cymru provides a number of self-management course and workshops for people living with any long-term health condition or caring role. These courses provide an opportunity for people to learn new coping skills, which can help improve the quality of daily life.

Groups of 8-16 participants, with a variety of different conditions, meet over six weekly sessions of 2½ hours per week. They are led through a structured course by trained tutors. Each session looks at ways to help manage the effects of their long-term condition such as:

  • Managing symptoms such as pain and tiredness
  • Dealing with anger, fear and frustration
  • Coping with stress, depression and low self-image
  • Eating healthily
  • Learning relaxation techniques and taking regular exercise
  • Improved communication with family, friends and health professionals
  • Planning for the future

The courses are led by two tutors, who themselves have experience of making life changes as a result of a long-term health condition. The majority of EPP tutors are volunteers. EPP courses are run in suitable venues in local communities and are free of charge.

The course does not provide any health condition or treatment information, nor does it look at specific health needs. The aim of our EPP Cymru courses is to give participants the confidence to take responsibility for their own care, whilst also encouraging them to work in partnership with health and social care professionals. What makes EPP Cymru special is the sharing of skills and experience with people who have to deal with the same things as each other.

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Facts

Many GPs who care for people with chronic (long-term) conditions say that the patient understands the condition better than they do. This is not surprising. Many patients become experts as they learn to cope with their chronic conditions.

There is evidence that, with proper support, people with a chronic condition can take the lead in managing their condition. This helps to improve their health and quality of life, and reduces their incapacity (lack of strength or ability).

An expert patient is someone who:

  • feels confident and in control of their life
  • aims to manage their condition and its treatment in partnership with healthcare professionals
  • communicates effectively with professionals and is willing to share responsibility for treatment
  • is realistic about how their condition affects them and their family
  • uses their skills and knowledge to lead a full life

Self-management

Self-management programmes are not simply about educating you about your condition. They also aim to enable you to take control of your health by learning new skills to manage your condition on a daily basis.

The primary method behind EPP was developed in California by Kate Lorig, an American professor. Her work with people with arthritis made her realise that many people with the condition have developed ways of coping and solving problems.

Professor Lorig and some of her colleagues decided to pool this information and develop a course that would help people manage their own arthritis. They realised that the problems that are faced by people with arthritis are often faced by people with other chronic conditions. For example:

  • pain management
  • stress (when too much pressure is placed on you)
  • low self-image
  • depression (feelings of extreme sadness, despair or inadequacy)

This led to the development of the Chronic Disease Self-Management Course, on which EPP courses are based.

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How does it work?

EPP courses are open those who are living with a chronic (long-term) condition.

The courses available are:

Chronic Disease Self Management Programme (Original Course)

Groups of 8-16 participants, with a variety of different conditions, meet over six weekly sessions of 2½ hours per week. They are led through a structured course by trained tutors. Each session looks at ways to help manage the effects of their long-term condition such as:

  • Managing symptoms such as pain and tiredness
  • Dealing with anger, fear and frustration
  • Coping with stress, depression and low self-image
  • Eating healthily
  • Learning relaxation techniques and taking regular exercise
  • Improved communication with family, friends and health professionals
  • Planning for the future

The courses are led by two tutors, who themselves have experience of making life changes as a result of a long-term health condition. The majority of EPP Cymru tutors are volunteers. EPP Cymru courses are run in suitable venues in local communities and are free of charge.

The course does not provide any health condition or treatment information, nor does it look at specific health needs. The aim of our EPP Cymru courses is to give participants the confidence to take responsibility for their own care, whilst also encouraging them to work in partnership with health and social care professionals. What makes EPP Cymru special is the sharing of skills and experience with people who have to deal with the same things as each other.

Looking After Me

The course helps carers to learn ways in which they can look after their own health needs whilst they are caring for another person and to cope with that caring situation. It also helps develop the confidence for them to take greater control of their lives and it gives an opportunity to meet with others who share similar experiences.

The course is open to any adult who is a carer (they do not need to have a condition themsleves to attend this course). It is run in the local community and is led by two volunteer tutors who themselves have experience of caring.

Courses are now available right across Wales. Many EPP Co-ordinators arrange courses for a number of areas.

The benefits

According to research, the benefits of self-management include:

  • reducing the severity of symptoms
  • significantly decreasing pain
  • improving life control and activity
  • improving resourcefulness and life satisfaction

In particular, one survey of 1,000 people who had taken part in an EPP found that they:

  • felt more confident that their symptoms would not interfere with their lives
  • felt better prepared for appointments with healthcare professionals
  • made fewer visits to their GP
  • made fewer visits to accident and emergency (A&E)

An evaluation of the EPP by the National Primary Care Research and Development Centre (NPCRDC) found that the EPP course increased people’s self-efficacy (their self-confidence to change their behaviour). The results also highlighted that the number of overnight stays in hospitals was reduced, and that the overall amount that people used health services remained the same.

Contact details

For further details about EPP courses in your area contact the National Leadership and Innovation Agency for Healthcare (NLIAH) on 01443 233514.

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