Interviews

This page is for interviews with the Self Care Forum Board:

Board member Dr John Chisholm CBE outlines his motivation for joining the Self Care Forum

Dr John ChisholmDr John Chisholm

What does the Self Care Forum mean to you?
The purpose of the Forum is to further the reach of self care and to embed it into everyday life, so as to establish it as a lifelong habit and culture. It brings together individuals who are passionately committed to self care in a Forum that allows the sharing of knowledge and experience and fosters learning from each other.

Why did you get involved?
I have been committed to self care for many years. I led the negotiations of the 2004 new GP contract that led to the funding and establishment of the NHS Working in Partnership Programme (WiPP). I subsequently became an adviser to WiPP and a member of the Steering Groups of most of its thirteen projects and was a signatory to the Self Care Campaign that preceded the establishment of the Self Care Forum. I also have a particular interest in getting health education about self care into the National Curriculum in schools.

What do you want the Self Care Forum to achieve in the next three years?
I want the Self Care Forum to deliver its nine terms of reference* and, in particular, to ensure that self care aware consultations become routine practice and that patients and the public are more confident, empowered and self-reliant about their self care choices. Taking responsibility for, and developing a more active role, in maintaining health, promoting good health, preventing ill health and dealing with both minor ailments and long-term conditions should be sensible behaviour for individuals, including children and teenagers. Empowering the public benefits quality of life, whereas uncertainty and fear damage wellbeing. Educating people to change their behaviours will not only benefit them and their families but inculcate life-long patterns of behaviour that will benefit their future health and wellbeing.

What are the benefits for people in adopting a self care approach?
Changing behaviour (in line with the Wanless modelling of the ‘fully engaged scenario’ for a sustained NHS) will:

  • reduce demand on the NHS and ensure that it is used in the most cost-effective way
  • change dependency behavior, while improving people’s ability to care for their own and their families’ health and wellbeing, resulting ultimately in the fully engaged consumers who:
    • are happier
    • are confident about when and what to do about looking after their own and their family’s health and illnes
    • know when to consult a GP and when to consult a nurse, pharmacist or other healthcare professiona
    • are not inappropriately dependent on the NHS and use NHS resources wisel
    • know how to prevent illness as well as self-treat minor ailment
    • respond to messages about self care and self-medication by acting upon the
    • will be less dependent on GPs when faced with long-term conditions
    • are prepared to discuss with and potentially to challenge healthcare professionals about what they want by way of support in caring for themselves.

Overall, self care will result in an improvement in the overall quality of care and life for all.

What are the benefits for healthcare professionals if they encourage a self care approach?
Minor ailments account for a high volume of general practice consultations, resulting in significant costs for the NHS. Encouraging self care is not primarily about reducing unnecessary consultations so much as about empowerment, confidence and self-reliance, which will underpin appropriate consulting behaviour. It is certainly not about deterring patients from seeking professional advice when they are worried. Nonetheless, one aim of the Self Care Forum is to introduce a social marketing campaign to educate people to understand and manage minor ailments with the right information, including information about when to seek appropriate professional help, so that GPs’ and practice nurses’ time is freed up to look after patients with more complex conditions.

What are the benefits for the NHS of a self care approach?
Achieving the Wanless fully engaged scenario, which includes a better informed, educated and empowered public, will reduce demand on the NHS and ensure that it is used in a more cost-effective way. This is particularly important with an ageing population and the increasing prevalence of long-term conditions.

What is your top tip for self care?
Consistency in terms of information and education needs to be delivered at national level as well as locally within health care teams.

What advice would you give to someone reluctant to implement self care?
I would seek to persuade both clinicians and patients that self care is about encouraging patient empowerment, confidence and self-reliance and improving health and wellbeing.

Is promoting self care all about reducing NHS costs?
Promoting self care is certainly not ‘all about reducing NHS costs’. Encouraging self care is primarily about engendering empowerment, confidence and self-reliance. While self care will help to reduce demand on the NHS and ensure that it is used in a more cost-effective way, that is not its prime purpose, but a consequence of doing the right thing for patients and the public.

Do people really want to change and make the move to self care?
People have to be helped to make beneficial changes. Making changes is easier for some people and more difficult for others; not everyone is at the same point of readiness to change. Self care requires consistent information, education, encouragement and support, and also cultural change involving patients (including children and teenagers and their parents), the public and health care professionals. Consistency in terms of information and education needs to be delivered at national level as well as locally. Healthcare professionals, especially GPs and practice nurses, need to be enabled to support people to feel confident enough to use the NHS at the point of need, not demand. Additionally, a social marketing campaign is needed, to educate people to understand and manage minor ailments with the right information, including information about when to seek appropriate professional help.

Do healthcare professionals trust people to make the change?
We have been moving over the past half-century from a paternalistic relationship between healthcare professionals (particularly doctors) and patients to one that is based more on partnership and on facilitating patient choice rather than imposing professionals’ choices on their patients. That gradual shift is about trust. While trust is at the centre of the consultation and the relationship between professionals and their patients, some professionals find it harder to let go of their paternalism than others. That is why the Self Care Forum is committed to enabling healthcare professionals, especially GPs and practice nurses, to support people to feel confident in their self care choices.

Board member Dr Knut Schroeder outlines his motivation for joining the Self Care Forum

Dr Knut SchroederDr Knut Schroeder

What does the Self Care Forum mean to you?
I enjoy being part of a group of committed and enthusiastic individuals from different professions and backgrounds who are all keen to help promote self care within the NHS. It’s a great privilege for me to share and help develop new ideas that could make a big difference for patients, health professionals and the wider NHS.

Why did you get involved?
I feel passionate about promoting the value of better self care in the wider NHS – and, indeed, globally. I truly believe that better self care is good for both people and healthcare providers. Self care does not mean less care, but instead better healthcare. I experience on a daily basis how better self care can make a big difference to people’s lives – they are more in control and feel better for being able to take charge of their health as and when appropriate. And so it’s really important that we spread good practice in this area. The Self Care Forum provides a fantastic platform and good opportunities to achieve this.

What do you want the Self Care Forum to achieve in the next three years?
I would be keen to see self care being more firmly embedded in the NHS agenda and also hope that it will become an integral part of general practice. I hope that in three years’ time people will have even better access to high quality information on self care, have demonstrably improved knowledge and achieved better health outcomes because they’re able to self-care – in both acute and chronic medical conditions.

What are the benefits for people in adopting a self care approach?
People adopting better self care who have the necessary knowledge and skills feel more empowered and confident to deal with many health problems themselves. This will often save them time and possibly money when this can avoid a trip to the doctor. Perhaps even more importantly, people often feel less anxious and worry less about self-limiting illness when they’re confident in self-diagnosing and self-managing common medical problems. And an appropriate self care approach can also mean that people get the medical care they need much quicker. This is particularly true in situations when access to healthcare may not be immediate because of waiting times. Confident self treatment with analgesia and other over-the-counter preparations can make a huge difference to people’s quality of life.

What are the benefits for healthcare professionals if they encourage a self care approach?
Encouraging a self care approach can help reduce inappropriate consultations in the future, both for minor medical problems as well as part of chronic disease management. But better skills in self diagnosis and self management can also mean that people are able to recognise potentially serious medical problems (such as cancer, stroke or heart attack) much earlier. Being able to tell the difference between serious and non-serious symptoms and signs is a very important part of this.

What are the benefits for the NHS of a self care approach?
Better self care can have enormous benefits for the NHS in terms of better health outcomes and better patient satisfaction. Appropriate self care could lead to potentially enormous cost savings by reducing the number of unnecessary consultations – and by earlier diagnosis of more serious conditions.

Any other benefits of self care?
Better self care is also better for the environment, as it can save on unnecessary appointments, reduces patient travel, and potentially saves the need for additional prescribing. A win-win all-round!

What is your top tip for self care?
Learn to self-diagnose better. This can help you identify common medical problems and tell the difference between serious and harmless medical problems. Lots of information is available to help you achieve this (through the NHS Choices website, www.nhs.uk, for example).

What advice would you give to someone reluctant to implement self care?
Learn more about when it’s safe to self care – and just try it! In many cases it’s easier than boiling an egg, and confidence comes with practice.

Is promoting self care all about reducing NHS costs?
No, it’s about providing better and more appropriate care that primarily benefits people. Better self care can save people time and money, gives people a feeling of control, reduces anxiety, improves quality of life – and leads to better disease outcomes.

Do people really want to change and make the move to self care?
All the people I know who have adopted a self care approach have felt better for it. Many people don’t want to bother health professionals unnecessarily and would rather treat themselves than having to take time off work or organise child care to make time to see a health professional. But dealing with health problems yourself can sometimes be a bit scary – which is why it’s so important that people have the right information to gain the necessary knowledge and skills to deal with certain health problems themselves.

Do healthcare professionals trust people to make the change?
With more and more high quality health information being available on the internet, in books and through leaflets, many health professionals now enjoy having better and higher level discussions with people who are more knowledgeable about their health. In the same way that people don’t have to be a mechanic to deal with minor car problems, they don’t have to have medical training to tackle certain health problems themselves. Is important, though, that people always feel supported by trusted health professionals, and that they can get access to medical advice as and when they need it.

Board member Professor Mike Pringle CBE, explains what motivates his involvement with the Self Care Forum

Mike PringleMike Pringle

What does the Self Care Forum mean to you?
Self care is important but there has been no real consistent attempt to promote its value. The Forum should allow us to devise an integrated policy, communication and action plan to encourage self care.

Why did you get involved?
I chaired a PCT research project on Self Care in 2004-2006. This showed people encouraged to self care were more likely to make changes to reduce their risk of heart disease, had greater confidence in managing asthma and improved mums’ understanding of minor children’s ailments and their ability to deal with these rather than seeing their doctor. To me it demonstrated the potential value of self care; we just need to replicate this approach across the country.

[For more details of the project, click here and details of the clinical paper click here: http://journals.cambridge.org/action/displayAbstract;jsessionid=9AECD8560C1A74D84F19989B44C352E0.journals?fromPage=online&aid=5468168]

What do you want the Self Care Forum to achieve in the next three years?
I want to raise public and professional awareness of the value and role of self care. It’s an important area and it can make a real difference to the health of the nation.

What are the benefits for people in adopting a self care approach?
There are many benefits of self care. The Government is right to promote the concept of ‘No decision about me without me’ – and what fits better with that then self care?  It encourages better decision-making by patients when it is most important, they become more self-reliant and have an improved understanding of when to seek professional help. What this means in practice is that people that adopt a self care approach have better outcomes and health status.

What are the benefits for healthcare professionals if they encourage a self care approach?
The first thing a health professional may notice is a potential reduction in demand management. Better involved patients who become co-producers of health will not demand the services of a health professional when they feel more responsible and confident in managing their own health.

What are the benefits for the NHS of a self care approach?
For an organisation where resources are finite, self care is a more cost-effective use of health service resources.

What is your top tip for self care?
For patient confidence in self care to be fully developed, they need to receive consistent advice and messages from health professionals and the Government. Every interaction the patient has with the health service has to promote the self care message for this to work.

What advice would you give to someone reluctant to implement self care?
It is already the reality for many patients – we just need to make sure it is spread further in a safe, joined up manner.

Is promoting self care all about reducing NHS costs?
No, cost-saving is not the reason for implementing self-care, but it is a part of the story.

Do people really want to change and make the move to self care?
I see more and more people seeking to take control of their health and illnesses.  Fewer people are willing to be passive recipients of health care and so my hope is that if we pull together and give people consistency in the advice and information we give them then they’ll take self care up as the first step to health.

Do healthcare professionals trust people to make the change?
People are making the change already. Health professionals need to realise that, with the right education and tools, the number of people practising self care will only increase but they will be better informed and with better control of their health, and that can only benefit all of us.

Professor Mike Pringle retired in 2015 and is no longer a Self Care Forum Board member

“Stop and think before calling the doctor”, advises Self Care Forum Board Member Sara Richards

Sara RichardsSara Richards

What does the Self Care Forum mean to you?
It helps me to fulfil a working ambition to encourage people to care for themselves. In addition, I can use the experience and networks I have gained working for many years in the primary care sector to further the aims of the Forum.

Why did you get involved?
I have been interested in encouraging people to self care for a very long time and wrote a seminal booklet for the International Council of Nurses in 2006 on Responsible self medication. I met Gopa Mitra when I was Chair of the Royal College of Nurses’ Practice Nurses Association and immediately became a Champion for self care when the Forum was in its infancy. She and I have pushed the self care agenda together in a number of settings which included being trustees of the charity Developing Patient Partnerships that provided excellent information for general practices, patients and the public. It seems such a shame we don’t have it now.

What do you want the Self Care Forum to achieve in the next three years?
I would like every GP and Practice Nurse to have heard of the Forum and for them to have taken the Royal College of General Practitioners’ eLearning course supporting self care for minor ailments and to apply the principles to both the self care of minor ailments and the self management of long term conditions.

What are the benefits for people in adopting a self care approach?
There are many benefits, such as being able to initiate self care as soon as a minor ailment happens rather than waiting for a doctor’s appointment, being able to self care at work, with perhaps only time off to rest rather than time off to visit the doctor. Also, undertaking self care at night, on holiday or on a work trip can make a difference as knowing what to do when a minor ailment arises can lessen the stress involved.

What are the benefits for healthcare professionals if they encourage a self care approach?
What I experience is a much more relaxed appointment with a person who has tried self care. I work at a walk in centre and by the time I have seen 15 people with a cold or sore throat who have not undertaken any self care, I do tend to get a bit annoyed! It’s a better use of a healthcare professional’s time if people have done some self care.

What are the benefits for the NHS of a self care approach?
I think people are less likely to turn to A&E and reserve visits to their GP or nurse only when they really need advice and medication.

What is your top tip for self care?
It’s simple: stop and think before ringing the doctor or going to A&E, you are capable of caring for yourself.

What advice would you give to someone reluctant to implement self care?
We all get ill from time to time and most times rest, analgesics and fluids are all that’s needed to help aid recovery. Your instinct will tell you when something is more serious, so think before reaching for the phone. Be prepared by reading information on NHS Choices or patient.co.uk and follow that advice.

Is promoting self care all about reducing NHS costs?
No, not at all, it is about enabling people to be confident in caring for their minor ailments and for themselves. The Self Care Forum is working developing information about what to expect with minor ailments – their normal duration – and what to look out for when it’s better to see a doctor, nurse or pharmacist. So this should help people to get a better handle on when it’s safe to self care and when it’s not.

Do people really want to change and make the move to self care?
I think people do when encouraged to think about it.

Do healthcare professionals trust people to make the change?
This rather goes against the grain for many health professionals as they have been taught that what they advise is best and the patient should do as he/she is told. If health professionals listened to people more they will see that most people do know what to do and they just need reassuring that what they think is the right way to cope.

Since being interviewed, Sara Richards has stepped down from the Self Care Forum Board