In this article Anne Kennedy and Anne Rogers of the University of Southampton explore findings from the WISE programme, which attempted to implement and embed a routine self-management support system in GP practices in areas of high deprivation. They identify the importance of social networks and support in enabling people to manage their condition, with implications for how services support people to self-manage.

The WISE programme found that despite the training and enthusiasm from both the wider health organisations and practice staff, overall GPs and nurses did not use the approach to change the way they engaged with patients during consultations. They did not have shared discussions about what sort of support patients needed or wanted and did not direct or refer patients to other local sources of support to the extent needed to improve patients’ health outcomes.

The authors note that the primary care business model rewards practices for clinical activity rather than other forms of support and that patients themselves also expect only medical input from primary care health professionals. Whilst practices do not generally refer people into social networks, the authors cite research showing that people’s social involvement with local groups and personal networks (including healthcare professionals) can impact on their ability to manage a health condition.

They conclude that the future lies in focusing on ways to assist with helping people build up and use diverse and supportive networks as a means of creating the lasting benefits of autonomy, mutuality and reciprocity.