STATEMENT ABOUT THE FUTURE OF SELF MANAGEMENT UK – ISSUED 31 JULY 2023

With regret the Board of Trustees of Self Management UK has decided immediately to commence a managed closure of the charity’s operations, which will cease by 31 August 2023.

Self Management UK’s mission is patient focussed. It has a 20-year history of running courses which support people with a variety of long-term health conditions to self-manage their conditions. It has evidenced that this results in better outcomes for people who access group self-management support, including reduced anxiety, increased activation in their health and care, and reduced demand on GP and hospital services – particularly unplanned A&E admissions. The charity has supported over 160,000 people to access supported self-management. It has been particularly successful in working with those who experience obstacles to accessing healthcare and who are on the receiving end of health inequalities.

After speedily developing on-line courses in response to the COVID pandemic, some courses saw a 70% increase in participation from often excluded populations, particularly men aged between 25 and 55 years from Black, African and Caribbean communities seeking support for mental health. The charity is incredibly proud that various commissioners acknowledged that it was the only community provider to responded at pace in order to continue to deliver its support services, and to return to pre-pandemic levels of activity.
Unfortunately current NHS priorities do not include the need to provide strategic support for self-management activities. In addition, the re-organisation of the NHS into Integrated Care Boards / Systems [ICBs/ICSs], which took effect in July 2022, continues to have an impact on delivery partners. There continues to be a lack of clarity in commissioning priorities, increased delays in decision making, knowledge loss through changes of personnel, and confusion over budgets and their allocation and control.

This left Self Management UK dependent on the support of some of its longest standing NHS commissioners, who recently decided not to extend key contracts for the provision of the charity’s courses. These decisions were unexpected and communicated at short notice.
Self Management UK exists to support those with long term health conditions. But the Trustees of Self Management UK are also responsible for its governance and are committed to meeting all the charity’s statutory obligations. They have been very closely monitoring the organisation’s finances over the last 18 months, to ensure that available cash does not fall below the estimated cost of winding up the charity should that become necessary. Unfortunately, it is now clear, following the events referred to above, that without urgent action this point will be reached around the end of August 2023. There is no viable prospect of sufficient additional funding being obtained prior to this, at levels that would extend the charity’s life span without the risk of increased liabilities.

Nigel Turner, Chair, said: “Self Management UK survived the COVID pandemic, although with weakened financial resilience. Despite strong evidence that Supported Self Management reduces demand in the primary and acute healthcare sector, we have been swimming against the NHS tide to have our highly effective self-management courses commissioned. Recent NHS commissioning decisions mean that we cannot remain financially viable beyond 31 August.”

Ian Silver, Chief Executive, said, “It is very disappointing that people with long-term health conditions will no longer benefit from the support we offer, which has been evidenced to provide better outcomes for them. Our priority now is for a managed closure of our activities. I would like to offer heartfelt thanks to our staff and volunteers who have contributed so much to our success over the last two decades.”

The Trustees and the senior management of the charity are in the process of opening dialogue with staff and discussions with current commissioners and funders. When operations close by 31 August, the charity will not immediately cease to exist and the voluntary Trustees will give thought to how to retain the knowledge base built up over two decades of delivering Supported Self Management.

NOTES

Self Management UK runs courses for people with long-term health conditions. Some courses are face-to-face and others online using Zoom. Courses are produced in conjunction with people with long-term health conditions and many are peer-led, i.e. by people who themselves have a long-term health condition. Specific courses for people with diabetes are run using the X-PERT framework, with tutors trained and accredited under that framework.

Established in 2002 within the then Department of Health, and later as a Community Interest Company, the charity has supported over 160,000 people through access to Supported Self Management, at no cost to course participants. The evidence for Supported Self Management is clear, including reductions in anxiety, increased activation in health and care and reduced demand on GP and hospital services, particularly unplanned Accident & Emergency admissions. Despite its inclusion in the NHS Long-term plan, there is no national strategy for Supported Self Management in England, unlike the approach taken by NHS Scotland.

The NHS waiting list now stands at more than 7.4 million people, with over 350,000 people waiting more than a year for treatment. As the NHS faces unprecedented increasing demand, the role of Supported Self Management is more important than ever. Charities like Self Management UK could be a crucial part of the solution, with the experience, resources and infrastructures already in place to support those most in need at a local level. Despite this, Integrated Care Boards continue to diminish the importance of the increasingly fragile voluntary sector, diverting funding to ‘in house’ initiatives and offering free (to the ICB) alternatives to its patients. These alternatives tend not offer the level of support required to address the challenges both people and the system face. This a short-term view that will unfortunately lead to even greater challenges faced by the system in years to come, but with the preceding loss of knowledge and expertise from the communities and populations it aims to support.

Self Management UK is a registered charity (number 1146727) and registered company limited by guarantee (number 07998365). Its voluntary, non-executive board members are trustees of the charity and directors of the company. It has 10 staff as at 10 July 2023. For more information please contact Ian Silver, Chief Executive: [email protected]