Table 1 Specification of WISE implementation strategy

Actors

The organisation: employs and supports lay trainers to deliver WISE to whole practice teams

Health care professionals: once trained, use WISE approach with their patients

Actions

Practice teams given knowledge, skills and tools to improve self-management support

Action targets

The organisation: facilitates training process (funding for training and employment of trainers), access to community resources (online directory of self-care organisations), develops management strategy, finds local GP champion

The practice: commit whole practice to attending training, nominate two practice champions for WISE, develop systems to ensure tools accessible to staff and patients, work with trainers in follow-up sessions to embed WISE, share and discuss learning within practice teams

Practice staff: use WISE approach knowledge, skills and tools to provide tailored support for self-management

Patients: given PRISMS form and informed of a change of approach by practice staff to help them manage their condition

Temporality

Assumption that practice staff would start to use WISE approach with patients with long-term conditions after completing training

Dose

Two training sessions of 3 h 1 month apart. Intermediate session and post-training support with trainers offered

Session 1: 3 h whole practice—GPs, nurses and administrative staff

  Brief introduction to WISE

  Care pathways exercise—mapping the process of care from reception to self-management

  Interactive session—making the WISE tools work in your practice:

   PRISMS form (Patient Report Informing Self-Management Support): designed to encourage patients to reflect on their support needs, how they were managing and which symptoms and illness-related matters required attention in their everyday lives. Patients' priorities to form a basis for negotiated decision-making and tailoring access to appropriate information or resources

   Guidebooks developed with patients to provide experientially based information, alongside medical evidence about treatment options [18],[19]. The guidebooks were intended to encourage patients to consider changes they could make to manage their condition

   Online directory of local services developed by the PCT providing up-to-date information about community services, support groups and education programmes. Linking to:

    Group training and support (Expert Patients Programme courses, group education, exercise classes)

    Voluntary sector and local support (patient support groups, health trainers)

Session 2: 3 h clinicians—GPs and nurses

   Refresh on WISE approach

   Show DVD giving examples of WISE approach consultations plus discussion

   Skills training—role play to practice three core skills:

    How to assess what each patient can do and needs to do

    How to share decisions with patients

    How to make sure patients get the right support

   Discussion on how to ensure sustainability of WISE

Implementation outcome affected

Adoption and feasibility of the WISE approach at organisation, practice, professional and patient level

Justification

Using NPT to explain how new or modified practices of thinking, enacting and organising work associated with WISE are operationalised in health care