The Living Self-Care Survey Study sheds light on who’s getting left behind
The Self-Care Forum, in collaboration with the Self-Care Academic Research Unit (SCARU) at Imperial College London, spearheaded the Living Self-Care Survey Study to understand people’s self-care confidence, health professional support and health literacy levels.
3,255 UK adults took part in one of the largest national studies ever conducted on self-care and the findings reveals stark demographic differences in how people manage common health symptoms and what gets in the way.
The results are both empowering and alarming. Older people are more confident in self-care. Men, people with disabilities and those with long-term conditions are not. Ethnic minorities show higher self-care confidence but are less likely to look for health information. And despite a strong culture of self-management, pharmacists and digital resources remain underused. This is more than a behaviour gap, it’s a structural injustice.
Self-care is happening, but it’s happening unevenly and often unsupported. If we want to close the self-care gap, we need to address what holds people back. Our study found clear disparities in self-care practises. To support better self-care, we must tailor interventions to specific groups. Strengthening pharmacy-led community support and improving access to digital health tools could be transformative to empowering diverse populations. Dr Pete Smith. O.B. E, President of the Self-Care Forum
The self-care paradox: high confidence, low engagement
The study found that 91% of people felt confident managing common symptoms, 4% consult a GP and just 1.3% spoke to a pharmacist with fewer than 10% consulting in digital health tools like NHS websites. Instead, people overwhelmingly turned to over-the-counter (OTC) medications or waited it out, reinforcing the “symptom iceberg,” where most health concerns never reach a GP’s desk. Barriers go beyond behaviour. They’re about time, trust and access. When asked why they didn’t engage in self-care more often, 53% cited financial constraints, 47% said they didn’t have enough time, 22% lacked confidence and 17% said they couldn’t find trustworthy information. This suggests that many people, especially those most at risk of poor health outcomes, are being locked out of self-care by systemic barriers, not personal disinterest.
A missed opportunity: pharmacists as self-care allies
Despite national policies calling for greater pharmacist-led self-care, engagement was minimal. For almost every symptom, <3% of respondents consulted a pharmacist despite widespread OTC medication use. This underlines the need for Investment in pharmacist training and public-facing roles, remuneration models that support self-care advice and public education to reframe pharmacists as accessible health advisors.
Disconnect between patients and health professionals
The data also revealed a clear disconnect between how patients and healthcare professionals view self-care. While patients believe they are already practising self-care and want more responsibility for managing their health, healthcare professionals often see patients as reluctant to engage in self-care. This finding shows the need for better communication and a shared understanding between patients and health professionals.
What needs to happen next
The findings support a shift from individualised responsibility toward systemic support tailored interventions for groups with lower self-care confidence (men, younger adults, those with long-term conditions). We also need more targeted health literacy campaigns that go beyond generic messaging to target trust, culture and motivation, and to redesign of digital health resources to improve navigation, trustworthiness and accessibility.
Self-care is not just a personal decision. It’s shaped by policy, systems and culture. The findings of the Living Self-Care Survey Study are a wake-up call. If the NHS is to remain sustainable, we must ensure everyone has the knowledge, confidence, support and tools to self-care effectively. But make no mistake, the self-care divide is real. But it’s not inevitable. With the right interventions, we can bridge it. Dr Austen El-Osta, Director of SCARU, Imperial College London
