Everyday heroes – patients taking back control

Many of you have heard me talk about our growing and ageing population and the pressure this places on an already stretched health system.  As we live longer, our rates of chronic and long-term disease, such as diabetes, lung and heart disease increase.  In fact there are 67,000 people currently living with long term illness in Counties Manukau – with many dealing with preventable risk factors, such as high blood pressure, obesity and mental health conditions such as anxiety and depression. The effect this has on a person’s life is immense, with many struggling with everyday tasks, such as walking to the letterbox, going to the shops or mowing the lawn.   For some there are months or years off work, continually feeling tired and unwell, and frequent trips to hospital or outpatient appointments.  From a health professional’s perspective there are greater demands on resources, rising costs and an underlying feeling we are only just scratching the surface.

While we do a great job of treating patients when they come in to hospital, there is a lot we can learn about supporting people with long term conditions in our community. One way we can help is by providing people with the tools, support and programmes they need to keep themselves well.   Instead of being a passive participant in their care, patients and whaanau take on a more active role.  

We are starting to see this in action with Campaigns such as 20,000 Days, Beyond 20,000 Days, ARI (At Risk Individuals) and Manaaki Hauora – Supporting Wellness (known as Self- Management Support).    These campaigns aim to equip, motivate, inspire and empower people to take back control of their health and their lives.

A great example of this in action is the Beyond 20,000 Days Healthy Hearts – Fit to Exercise Programme, which aims to improve the quality of life of people with heart failure living in the Counties Manukau community.  At a recent graduation ceremony (see video), Isa Nacewa, Mental Skills/Performance coach for the Blues rugby team acknowledged the success of the Healthy Hearts participants, who had recently completed the community gym-based programme. As a former Blues player, Isa’s daily exercise regime stopped when he retired and he needed to find an exercise programme he could incorporate into his day-to-day life.   His weekly routine now includes walking with his mum, playing golf or taking his girls to the park.  Just shows you don’t need to buy expensive gadgets to keep active (although I am rather attached to my FitBit).



James was referred to the Healthy Hearts Fit to Exercise programme from the cardiology department following a recent review of his heart failure. Following the 9-week programme, which focused on individualised exercise and advice he feels like a new man. He can now mow his lawn (front and back) and walk his dog – two things he couldn’t do before. He is sharing his new- found knowledge with his two sons, who also have heart problems.

Fellow participant, Arthur is also sharing his exercise and nutrition tips with his sons. The whole family is involved in his care and when they go food shopping his children help him make healthy choices, which include checking the labels on food. As Arthur says, just because it says fat free doesn’t mean it’s sugar free!

Carlson is a great supporter of the programme and is looking forward to going back to work after 5 years of being at home. His son Jacob is proud of him, saying his dad can do more, is stronger and healthier.

To me these are the real heroes living in our community. By learning how to manage their conditions and stay well people are feeling healthier, fitter, happier and able to do things they couldn’t do before. To top it off they are sharing what they have learnt with others.

Just think what a difference we could make if we can motivate, inspire and empower people across Counties Manukau and beyond to become experts in their own care.




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Author: Geraint Martin

Geraint Martin was appointed Chief Executive Officer of Counties Manukau DHB in December 2006. It is one of the largest District Health Boards in New Zealand and services a population of half a million. He has significant experience over 30 years in national policy & in managing both primary and secondary care . Previously, he was Director of Health and Social Care Strategy at the Welsh Government .He authored a radical 10 year strategy of reform, including the successful “Saving 1000 lives” Campaign.Until 2004, he was CEO at Kettering General Hospital & had held senior positions in London & Birmingham.He has worked closely with clinicians in improving clinical standards,patient safety,chronic disease management & managing acute care to reduce hospital demand.In NZ, He has promoted clinical quality and leadership as central to improving patientcare. This has led to a significant increases in productivity and access, whilst maintaining financial balance. CMH has completed in 2014 a $500 m capital redevelopment programme, the largest in New Zealand. A central part of this is the establishment of Ko Awatea,the Centre for Innovation and Research which will underpin CMH as one of the the leading health systems in Australasia.In 2008, he chaired the Ministerial Review of Emergency Care in New Zealand, and in 2013 was an member of the Expert Advisory Panel on Health Sector Performance. Geraint has an MSc in Health Policy from Birmingham University .His post-graduate work has focused on health economics and Corporate Strategy . He is adjunct Professor of Healthcare Management at AUT and Victoria University, Wellington Elected in 2006 as a Companion of the Institute of Healthcare Management, previously he was an Associate Fellow at Birmingham University.He is is Chair of the Auckland Philharmonia Orchestra, a member of the Institute of Directors, on the Board of the NZ Institute of Health Management & previously the Board of The NZ Health Quality and Safety Commission.

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