The management of chronic disease and the contribution patients make to their own care is attracting widespread attention, nationally and internationally. A range of self-management courses have been developed by Kate Lorig and her team at Stanford University’s Medical School since the early 1980s, some of which have now been implemented throughout England and across other parts of the UK. Designed for people with long-term health conditions, they are delivered by hundreds of agencies worldwide, and differentiate the concept of disease management (to be done by a health care professional) from the individual’s management of life with a long-term condition (self-management).

This book explores how this work became valued within the NHS and local communities and also airs the arguments about the importance of lay leadership. It brings together those who have been instrumental in developing these courses, and assesses the value they hold for the different groups involved directly in them (participants, course trainers, staff), and those it will affect indirectly (GPs, nurses, policy makers, commissioners). The reader will find personal experience and accounts of the excitement in designing new work. Reflection on what happens to people attending courses is set alongside consideration of radical questions about the need for resilient communities. Next, the research reports are followed by considerations for policy makers and local agencies, voluntary and statutory. Finally, questions about the future direction and links to local communities are raised.