Support Needs Approach for Patients - SNAP

Enabling person-centred care in progressive conditions.

The Support Needs Approach for Patients (SNAP) is a five-stage health care intervention which seeks to enable person-centred care for patients with progressive conditions. SNAP uses an evidence-based validated tool, known as the SNAP Tool, to help patients identify and express their support needs so that they can discuss them with their health care professional.

The evidence for the SNAP Tool comes from:

Patients with progressive disease
Informal carers (family and friends who help and support patients)
Health care professionals

The SNAP Tool comprises 15 items (broad areas of support need) in which patients with progressive disease commonly say they require support. The tool is short and simple to use for both patients and health care professionals.

SNAP is more than just the 15-item tool: the SNAP Tool underpins the 5-stage SNAP intervention for use in clinical practice to deliver person-centred care. It enables the patient and health care professional to work together to identify, prioritise and plan in relation to the patient’s unmet support needs.

The SNAP Tool can also be used as a standalone tool in research studies where researchers want to identify broad areas of unmet support need in patients with progressive conditions.

Healthcare professionals can’t help patients meet their support needs unless they know what those support needs are. Patients can find it difficult to tell health care professionals what they need help with, or what they are worried about, for a whole range of reasons – but SNAP can help with this.

Patients and health care professionals say that: although the SNAP tool was initially developed for patients with advanced chronic lung disease (COPD), the generic nature of items of the tool mean it can be used for patients with other progressive or non-curative conditions such as heart failure or stroke.

Why do we need SNAP?

Some patients find it difficult to tell health care professionals about their support needs as they are:

Worried about health care professionals’ time
Not sure what it is appropriate to tell health care professionals about
Very aware that health care professionals have things they need to do during an appointment – and health care professionals tend to be “in the driving seat” of consultations

However, it’s difficult for health care professionals to meet patients’ support needs if they don’t know what those needs are. Patients need a tool to help them identify and express their support needs – a tool to help overcome their concerns about whether to share their needs, to act as a prompt. This could then help start a needs-led conversation with the health care professional about their unmet support needs, so that the patient and health care professional can work together to address those unmet needs.

The SNAP Tool uses a simple question and tick answer format so patients can show which areas they need more support with. The ‘visibility’ of common areas of support provided by the tool has been reported as helpful for patients.

SNAP is more than just the 15-item tool: the SNAP Tool underpins the 5-stage SNAP intervention for use in clinical practice to deliver person-centred care.

It enables the patient and health care professional to work together to identify, prioritise and plan in relation to the patient’s unmet support needs. Find out more on the SNAP website.

What are the five stages of SNAP?

SNAP is more than the SNAP tool. SNAP is a 5-stage person-centred intervention which is facilitated by the health care professional but led by the patient.

Within SNAP the patient is enabled to say what their unmet needs are and what they feel would help support them. It is person-centred in that at every one of the five stages the patient is at the centre of the activity – they are “in the driving seat”.

SNAP begins when patients are introduced to the SNAP tool.
Patients then use the SNAP tool to consider and indicate the areas in which they need more support – by answering the 15 evidence-based questions.
A needs-led conversation then takes place between the patient and the health care professional using the patient-completed tool, which enables the patient to prioritise and express their individual support needs.
Together, the patient and health care professional then agree on what (further) supportive input would be valuable and create a shared action plan.
A shared review of the patient’s support needs is then carried out, by the patient and health care professional, at another point in time.

Interestingly, healthcare professionals have described SNAP as opening needs-led conversations with patients even when those patients didn’t initially identify any support needs. SNAP has also opened conversations about needs that were unknown to healthcare professionals even when patients were well-known to them – which surprised them.

How can I access SNAP?

From the SNAP website you can:

Get an inspection copy of the SNAP tool
Request a licence to use the SNAP tool (free to NHS and not-for-profit organisations)
Access free 90 minute SNAP training (required for a clinical practice licence)

The website hosts information and resources about SNAP including downloadable materials, links to publications, meet the SNAP team, SNAP news and FAQs. The SNAP programme is led by Dr Morag Farquhar at our University, collaborating with Carole Gardener and Dr Gail Ewing from University of Cambridge and funded by NIHR SPCR and Marie Curie.

Gardener AC, Ewing G, Farquhar M. Enabling patients with advanced Chronic Obstructive Pulmonary Disease to identify and express their support needs to health care professionals: a qualitative study to develop a tool. Palliative Medicine 2019;33(6):663-675

Gardener AC, Ewing G, Mendonca S, Farquhar M. The Support Needs Approach for Patients (SNAP) tool: a validation study. BMJ Open 

Gardener AC, Ewing G, Kuhn I, Farquhar M. Support needs of patients with COPD: a systematic literature search and narrative review. International Journal of COPD 2018;13:1021-1035 

Visit the SNAP website for further information.