The Service Improvement Programme

The Service Improvement Programme aims to support the Co-creating Health sites to change and improve the way their health services are designed and operated so that they better support self-management. It provides the sites with information about self-management support systems as well as intensive change management support in the form of consultancy, facilitation and quality improvement training. The programme aims not only to create health services which can guarantee reliable, systematic delivery of self-management support, but also to build local skills and capability to achieve improvement which will last well beyond the life of Co-creating Health.

Enclosed in this pack are copies of a diverse set of materials used both in the UK and internationally to support self management initiatives. They range from examples of simple goal setting sheets, to a deck of cards used for agenda setting and copies of letters sent to patients to encourage them to consider important issues in advance of meeting with their health professional.

All have been produced for the specific requirements of a particular disease or clinical setting but will form a useful basis for materials you may wish to develop as part of your own self management initiatives. Understandably they may not, in their entirety, be suitable for the particular circumstances of your location, but all will have elements that have been proven to work with patients to help with agenda setting, goal setting and follow up.

When considering these examples - and they represent just a drop in the ocean of all the resources that are available - you may want to consider the following questions before developing your own materials. We would encourage you to test any materials with a small number of patients before using them across the board.
  • Which aspects of the examples are good? Layout, concise wording, easy to use, for example.
  • Which aspects of these examples don’t work well? For example, are they too wordy, not visual enough?
  • What audiences are these materials suitable for?
  • Would they reproduce well in colour?
  • Will there be language barriers for some groups
  • Can they be reproduced in languages other than English?
  • Which pictures work best – and are they realistic? For example, is a clip art picture of a young, smiling, slim girl the best picture to illustrate an exercise goal?
They are not designed to be a ‘one size fits all’ solution but we hope will inspire you to develop new materials according to the unique circumstances and patient needs in your location.

We are indebted to those individuals and practices who have willingly shared these resource examples with The Health Foundation for its Co-Creating Health project.

The Model for Improvement using the Plan, Do, Study, Act (PDSA) Cycle


The Model for Improvement (see right) is an improvement framework that is both widely applicable and easy to learn and use. This is the methodology that is being used to trial various examples to improve consultations. The worksheet below can be used to document a PDSA cycle.

PDSA Worksheet for Rapid Cycle Testing

Working on it!