Self care in the community

What: A health education programme that encourages local patients and staff to take responsibility for their health and wellbeing

Who: Anne Thomas – Staff Nurse

Background: Anne is a band 6 Staff Nurse, with a BSc in Health Studies and qualifications in Health Education and counselling. She also provides British Heart Foundation Training and smoking cessation and alcohol awareness training

Location: Betsi Cadwaladr University Health Board, Outpatient Department, Dolgellau Hospital, NHS Wales

Speciality: Community nursing and health promotion

What initiative or project are you involved in?

A health promotion hub that encourages local patients, staff and the community to make healthy lifestyle choices, and signposts to other available forms of help and support.

Working in a small hospital at the heart of a rural community, the outpatient team at Dolgellau Hospital provides an effective, patient-centred health education programme.

Since 2012, the team have developed several initiatives, including:

  • Healthy Hearts: a programme to support chronically ill patients who are at risk of cardiovascular disease or who would benefit from making positive lifestyle changes
  • an expansion of the Healthy Hearts programme to include rheumatoid patients; a study of these patients resulted in a research study of the effectiveness of the Healthy Hearts programme
  • Working for a Healthy Heart: an initiative developed for NHS staff.

National initiatives include:

  • patient support to reduce the risk of diabetic retinopathy
  • skin cancer recognition and prevention
  • prostate system support
  • support for carers; including health promotion, Carers’ Week and a weekly Carers Outreach service, Macmillan drop in sessions

What prompted the work?

Self care is a key theme in the Welsh Government’s Delivering Local Health care plan (2013). The focus is on providing support for people to adopt and maintain healthy lifestyles, as well as empowering them to manage and minimise the impact of long-term conditions on their day-to-day life.

Self care is part of a continuum of care, starting with the responsibility individuals have in making daily choices about their lifestyle, right through to major trauma where responsibility for care is entirely in the hands of the health care professionals, until the start of recovery when self care can begin again. The outpatient team at Dolgellau Hospital support people to self care at all points along the continuum.

The Rural Health Plan (Welsh Government 2013) and own research identified barriers to accessing health education in rural areas. The development of the Out Patient Department as a Health Promotion Hub aims to encourage the rural community to see it as a resource for good health as well as ill health.

What difference has the project or initiative made?

The change in focus to preventative health care has had a positive impact on patients, staff and community at no extra cost to the NHS.

What are the long-term objectives?

To make health education more accessible to the community by taking ‘Out Patients Out’. Including young people; learning disability groups; patients with chronic illness at home. To take the model of Health Promotion Hubs to other rural community hospitals

Patient Testimonials

‘The help, advice and support was beneficial in pointing out to me things I already knew but was not implementing in my lifestyle’ (68 year old female)

‘This approach for me is helpful as sometimes I think more about work than my own wellbeing’ (55 year old male)

‘The programme has helped me to address my health and weight issues without being made to feel guilty’ (45 year old female)


BCUHB 2012 Achievement Awards: Evidence into Practice: Healthy Hearts Programme
BCUHB 2013 Achievement Awards: Evidence into Practice: Healthy Hearts Programme/Rheumatology department collaboration
Shortlisted for 2014 Nursing Times Awards: ‘Working for a Healthy Heart: Promoting Rural Workplace Health and Wellbeing’
Nursing and Midwifery Awards 2014
BCUHB 2014 Achievement Awards Winner: Contribution to Improving the Health and Wellbeing of Staff in the Workplace
BCUHB 2015 Achievement Awards: ‘Working in Partnership’
RCN Nurse of the Year Award 2015, runner-up in ‘Improving Individual and Population Health’