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The study ‘Developing best practice for fungal specimen submission – fungal audit of general practice’ can be downloaded from the following link:
http://www.pulsetoday.co.uk/newsarticle-content/-/article_display_list/13744489/gps-urged-to-encourage-self-care-for-fungal-infections

On 20 March 2012, writing in the BMJ, the Health Foundation called for clear guidelines and standards to be developed on self management support for patients.  It highlighted the importance of supporting people to look after their own health stating ‘There is now an urgent need for NICE to produce guidance and standards on support for self management. We need to recognise people’s role in managing their own health and support them to develop the knowledge and skills to become confident self managers.’

In its response, the Self Care Forum asks that the NHS goes further “The purpose of the Self Care Forum is to further the reach of self care and embed this into everyday health care. To do this effectively goes beyond agreeing a set of quality standards, but requires the NHS to standardise the way in which it helps patients manage their own health. A holistic pan-NHS approach is needed which integrates consistent messages on self care and individual responsibility promoted at every touchpoint of a person’s NHS experience, whether primary or secondary care, an A&E or 111 interaction, and including advice from NHS Direct and NHS Choices.”

For the response go to: http://www.bmj.com/content/344/bmj.e2006?tab=responses

The Self Care Forum concurs with Eaton et al’s (1) belief that self-management should be included in NICE’s quality standards programme, but believes the response from NICE could be more encouraging.

A more proactive approach to self care is essential if the NHS is to better equip patients to become capable and confident in managing their health in the future. This begins with the ability and knowledge to handle everyday minor ailments so that patients are better placed to self manage long-term conditions as and when they strike in their lives.

The Self Care Forum believes organisations, such as NICE, can help to drive change, speed implementation and empower people toward a better health outcome. Adopting an integrated self care approach is synonymous with patient-centred care.

1. The importance of behavioural change and new tools to facilitate behavioural change
2. Patients: nudging patient behaviour

Click here to download the report in full

Key outputs from the report include:

• Health care costs are becoming unsustainable, in large part due to a chronic disease epidemic fuelled by unhealthy lifestyles, aging populations and increasing standards of living. To bring costs under control and improve health outcomes, patients and other stakeholders of the health care system will need to change their behaviour.
• To enable these behavioural changes, the epicentre of the health care system is shifting from the two places in which health care has traditionally been produced, delivered, consumed and paid for — the hospital and the doctor’s office — to a third place: the patient.
• Patients – who have grown increasingly comfortable with empowering technologies (e.g. smartphone apps, monitors, social media) are taking a more active role in managing their health and are demanding a different model.
• Getting people to adopt healthy behaviours represents a tremendous economic opportunity for life science companies and health care systems, but this has been extremely difficult despite patients’ best intentions.
• Behavioural economics demonstrates that the reason people fail to make behavioural changes is that they have predictable biases that affect decision making – leveraging the science of behavioural economics to understand human biases allows companies to construct incentives and create products/services that are far more likely to succeed.

If the benefits of self-care are to be communicated amongst the patient population, the means of communication is crucial. Talking to patients in their own terms and avoiding the use of jargon can greatly improve patient experience, and help empower patients to make healthy decisions with confidence. Dr Michael Dixon, chair of NHS Alliance, described this as a need to ‘de-professionalise’ and ‘hand power to our patients [to] enable them to self-care’.

‘De-professionalising’ means, for healthcare professionals, practising plain speaking and encouraging the provision of simple, manageable information and advice for patients. An over-professionalised consultation, riddled with incomprehensible medical terms, for instance, stands to alienate and confuse a patient – something that does not encourage empowered, informed self-care. Nor does it facilitate shared decision making.

Shared decision making and empowering patients is something that featured highly in Secretary of State for Health Andrew Lansley’s speech at Guy’s and St Thomas’ NHS Foundation Trust on 7 December. Lansley talked about the importance of professionals and patients working together, as well as educating patients on symptoms to look out for. He said: “We need to empower patients, their doctors and nurses to work together to get the best possible care. We need patients to be fully engaged in the decision making process. And we will help people to make the right decision when they are unsure whether to see their doctor or not. By helping people to recognise symptoms, we can help improve early diagnosis for things like cancer or dementia or other conditions. At the same time, we can help reduce the nearly 60 million visits to a general practice that don’t necessarily need a GP”.

Empowering patients is a question of understanding their rights and responsibilities, and encouraging them to do the same. Importantly, though, it is also a matter of engaging patients with their own healthcare by attempting to look at the healthcare experience from their perspective. Well-communicated, clear, simple advice – coupled with an awareness of the role the patient can play in the management of his/her own health – are the key to making self-care an easy choice.

Read the full speech here.

Shared care is key, because according to Professor Nigel Sparrow, chair of the Professional Development Board of the RCGP, it has the potential to ‘increase patient confidence and develop more effective use of primary care’.

It is hoped that increasing patient confidence will improve uptake of self-care among patients. But to facilitate this, there is a recognised need to increase the confidence of health professionals too – in their ability to promote self-care.

As a means of addressing this need the RCGP has launched an e-learning self-care course for health professionals entitled ‘Self Care for Minor Ailments’. The course has been designed by RCGP to aid GPs in developing consultation skills that empower patients to self-care.

Available for health professionals to access via the RCGP website, the course was funded by NHS Northwest. Susan Summers, assistant director of quality assurance and self-care at NHS North West Strategic Health Authority, explains the Authority’s decision to support the course:

‘If we are to halt the rise and prevalence of long term conditions, focus on prevention and upstream activity, including minor ailments, is critical – self-care is absolutely the catalyst for this, and this is why NHS North West felt it so important to fund the RCGP’s new online module. We are proud to have been involved and are sure the course will further the reach of self-care.’

There’s no doubt that courses like this will help ‘further the reach’ of self-care – by giving health professionals the support they need to best promote it among their patient populations.

“Shared care is the way of the future, and this not only means that patients must have the right skills – GPs also need to change their behaviour.”