The Expert Patients 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)
In England, there are 15.4 million people living with a chronic condition. This figure is expected to increase as the population ages, and if people continue to make unhealthy lifestyle choices.
The EPP
The EPP is an NHS initiative that was launched in 2002 to help patients with chronic conditions to take control of their lives. The basis of the programme is a training course that teaches people how to manage their conditions by using five core skills. These are:
problem solving
decision making
making the best use of resources
developing effective partnerships with healthcare providers
taking appropriate action
The EPP has been so successful that a national Expert Patients Programme Community Interest Company (EPP CIC) was launched in April 2007. Community Interest Companies are a form of social enterprise (businesses that are set up to meet a public need and reinvest their profits for the public good).
The EPP CIC provides free courses for people with a chronic condition to help them manage their condition better on a daily basisExpert patients
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.
About EPP courses
Expert Patients Programme (EPP) courses are open to anyone who is over 18 and living with a chronic (long-term) condition.
The EPP Course
The original EPP course covers the following topics:
dealing with pain and extreme tiredness
coping with feelings of depression
relaxation techniques and exercises
healthy eating
communicating with family, friends and healthcare professionals
planning for the future
The course is free and consists of six consecutive weekly sessions, with each session lasting around two-and-a-half hours. The sessions are run by two tutors who both have a chronic condition. You can participate as much or as little as you wish.
Alternative courses
Most EPP courses are designed to deal with any type of chronic condition, although some courses focus on a specific condition. For example, there is a course on diabetes and one on persistent (day-to-day) pain. There are also several courses for parents and guardians of children with chronic conditions.
For a full list of available courses and information about how to participate, visit the EEP Community Interest Company (EEP CIC) website.
Children 12-18 years of age
If you are 12-18 years of age and you are living with a chronic condition, there are workshops available for you. These are run by tutors who are 14-25 years of age and who also live with a chronic condition. You can find out more about the workshops on the Staying Positive website.
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, and any other general enquiries, contact the EPP CIC by telephone (020 7922 7860) or freephone (0800 988 5550).
The EPP CIC also offers resources, services and training to organisations that wish to run their own courses.
Arthritis is a common condition that causes pain and inflammation (swelling) of the joints and bones. The main symptoms of arthritis include:
pain
stiffness
restricted movements of the joints
inflammation and swelling
warmth and redness of the skin over the joint
In the UK, arthritis is a very common condition, affecting over nine million people.
The most common forms of arthritis are:
osteoarthritis
rheumatoid arthritis
The characteristics of these two conditions are discussed below. Other types of arthritis are listed in the box, below left.
What is osteoarthritis?
Osteoarthritis is the most common form of arthritis in the UK, affecting an estimated 8.5 million people.
In people affected by osteoarthritis, the cartilage (connective tissue) between their bones gradually wastes away (degenerates), leading to painful rubbing of bone on bone in the joints. The most frequently affected joints are in the:
hands
spine
knees
hips
Osteoarthritis often develops in people who are over 50 years of age. However, it can develop at any age as a result of an injury or another joint-related condition.
The cause of osteoarthritis is not fully understood. One theory is that some people are genetically predisposed to developing osteoarthritis, which means that they have an increased likelihood of inheriting it from their parents. However, this theory has not yet been proven.
See the Health A-Z topic about Osteoarthritis for more information and advice about the condition.
What is rheumatoid arthritis?
Rheumatoid arthritis is a more severe, but less common, form of arthritis than osteoarthritis. It occurs when the body's immune system attacks and destroys the affected joints, causing pain and swelling to occur. This can lead to a reduction in movement and the breakdown of bone and cartilage.
In the UK, rheumatoid arthritis affects around 350,000 people, and it often starts between 40 and 50 years of age. Women are three times more likely to be affected by the condition than men.
Rheumatoid arthritis is caused by a fault in the immune system (the body’s natural defence against illness and infection) that makes the body attack its own tissues. The fault may be inherited genetically (passed on from a family member).
See the Health A-Z topic about Rheumatoid arthritis for more information and advice about the condition.
Arthritis and children
Arthritis is often associated with older people, but sometimes it can also affect children. This is known as juvenile idiopathic arthritis (JIA). However, JIA is uncommon, affecting about one in 1,000 children.
The main types of JIA are discussed briefly below.
Oligo-articular JIA
Oligo-articular JIA is the most common type of JIA. It affects four or fewer joints in the body, most commonly in the knees, ankles and wrists.
Oligo-articular JIA has good recovery rates and long-term effects are rare.
However, there is a risk that children with the condition may develop eye problems, so it is advised that they should have regular eye checks with an eye care specialist (ophthalmologist).
Polyarticular JIA (or polyarthritis)
Polyarticular JIA (or polyarthritis) is type of JIA that affects five or more joints. It can develop at any age during childhood.
The symptoms of polyarticular JIA are similar to those of adult rheumatoid arthritis. The condition is often accompanied by a rash and a high temperature (fever) of 38C (100.4F) or above.
Systemic onset JIA
Systemic onset JIA begins with symptoms such as a fever, rash, lethargy (a lack of energy) and enlarged glands. Later on, joints may become swollen and inflamed. Like polyarticular JIA, systemic onset JIA can affect children of any age.
Enthesitis-related arthritis
Enthesitis-related arthritis is a type of juvenile arthritis that affects older boys or teenagers. The condition can cause pain in the soles of the feet and around the knee and hip joints, where the ligaments attach to the bone.
More information about arthritis in children can be found on the Arthritis Care website.
Outlook
There is no cure for arthritis, but there are a number of treatments that can help to slow down the condition’s progress. Medication can help to relieve the symptoms of arthritis and, in severe cases, surgery may be recommended.
For osteoarthritis, analgesics (painkillers), non-steroidal anti-inflammatory drugs (NSAIDs), and corticosteroids are often prescribed. In very severe cases, surgical procedures may be recommended such as:
arthroplasty (joint replacement therapy
arthodesis (joint fusion)
osteotomy (the addition or removal of bone)
See the Health A-Z topic about Osteoarthritis - treatment for more information about how the condition is treated.
In treating rheumatoid arthritis, the aim is to slow down the condition’s progress and minimise joint damage. Treatments that may be recommended for rheumatoid arthritis include:
analgesics (painkillers)
disease modifying anti-rheumatic drugs (DMARDs)
physiotherapy
regular exercise
See the Health A-Z topic about Rheumatoid arthritis - treatment for more information about how the condition is treated.
Support groups
There are several support groups, such as Arthritis Research UK and Arthritis Care that offer advice and support for people with arthritis and their families.
show glossary terms Other types of arthritis
There are over 200 different types of rheumatic diseases (conditions that cause aches and pains in a person’s bones, joints and muscles).
Some of the most common types of arthritis include:
ankylosing spondylitis - a chronic (long-term) type of arthritis that affects the bones, muscles and ligaments of the spine
cervical spondylitis - also known as degenerative osteoarthritis, cervical spondylitis affects the joints and bones in the neck
fibromyalgia - a condition that causes pain in the muscles, ligaments and tendons, as well as all over the body
lupus - a chronic (long-term) condition that causes inflammation in the body's tissues
gout - a type of arthritis that usually affects the big toe, but can develop in any joint in the body
psoriatic arthritis- joint inflammation that affects people with the skin condition, psoriasis
reactive arthritis - can cause inflammation of the joints, eyes, and urethra (the tube that runs from the bladder through the penis in men, or vulva in women, through which urine is passed)
secondary arthritis- a type of arthritis that can develop after a joint injury; it sometimes occurs many years after the injury
polymyalgia rheumatica - a condition where the immune system attacks healthy tissue, causing muscle pain, stiffness and joint inflammation
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Expert Patients Programme
A free six week course for anyone living with any long-term health condition(s). The programme aims to provide support and develop self confidence to help you feel more in control.
Expert Patients Programme is a free six week course for anyone living with any long-term health condition(s). The programme aims to provide support and develop self confidence to help you feel more in control.
The course looks at:
Dealing with pain and extreme tiredness
Coping with feelings of depression
Relaxation techniques and exercise
Healthy eating
Communicating with family, friends and professionals
Planning for the future
Practicalities
The Expert Patients Programme is run over six weekly sessions with each session lasting two-and-a-half hours. It is facilitated by trained tutors who are themselves living with a long-term condition. The course also has a number of accredited bilingual tutors, who deliver the courses in community languages in a culturally appropriate manner.
Who can take part?
Anyone living with one or more long-term health condition(s).
How can it help you?
By taking part in an Expert Patients Programme, you will:
Learn new skills to manage your health condition
Develop confidence in the daily management of your specific condition(s)
Meet others who share similar experiences
Learn about developing more effective relationships with healthcare professionals
How has it helped others?
People who have taken part in a Expert Patients Programme have reported that it has helped them to:
Feel confident and more in control of their life
Manage their condition and treatment together with healthcare professionals
Be realistic about the impact of the condition on themselves and their family
Use their new skills and knowledge to improve their quality of life
What course participants say
Gill - Godalming, Surrey
“Attending a course makes you realise it’s ok to be you – you are more than the pain or the long-term condition you have.”
I was diagnosed with a chronic pain syndrome and coccydynia after a minor accident in September 2004. I had damaged my coccyx and sacrum, and numerous medical interventions to relieve the pain had failed.
Having coccydynia means it is difficult to sit for a long period, which sounds like a small thing but it has quite an impact on daily life – sitting to eat a meal, driving, going to the theatre, using a computer – the list is endless!
More on Gill's story
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Georgie's Story
"My life has been transformed over the last two years and I can say with absolute certainty that I owe it all to the Expert Patients Programme."
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Susan's Story
“From my first session on the EPP CIC course I felt great relief. I would love to go on the course again!”
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Online Course
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Supporting Parents Programme is a free six week course for anyone who has care of a child with a long-term health condition. The programme aims to provide support and develop self confidence to help you feel more in control.
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The COPD and Breathlessness free course aims to equip people living with COPD and breathlessness with the confidence, skills and motivation to manage their condition effectively and take control of their lives.
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Persistent Pain Programme is a free self-management course for people who live with day-to-day persistent pain.
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This course helps people to manage their health better.
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Staying Positive
Staying Positive workshops are for 12-18 year olds and are run by people with long-term conditions who are aged between 14-25.
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Caring with Confidence
A programme aimed at improving support for carers aged 18 and over in England. You can develop your caring knowledge and skills by taking part in free local group sessions.
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