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What is self care?
The Self Care Forum’s definition of Self Care is:
The actions that individuals take for themselves, on behalf of and with others in order to develop, protect, maintain and improve their health, wellbeing or wellness.
The Self Care Continuum
The above continuum illustrates the sliding scale of self care in the UK, starting with the individual responsibility people take in making daily choices about their lifestyle, such as brushing their teeth, eating healthily or choosing to do exercise.
Moving along the scale, people can often take care of themselves when they have common symptoms such as sore throats, coughs etc, for example by using over-the-counter medicines. The same is true for long term conditions where people often self-manage without intervention from a health professional (DH figures state that people with long term conditions spend on average 4 hours a year with a health professional, which means the remaining 8756 hours are spent self-managing).
At the opposite end of the continuum is major trauma where responsibility for care is entirely in the hands of the healthcare professionals, until the start of recovery when self care can begin again.
The NHS can support people to self care at any point during the continuum.
Why is self care good for people?
Empowering people with the confidence and information to look after themselves when they can, and visit the GP when they need to, gives people greater control of their own health and encourages healthy behaviours that help prevent ill health in the long-term. In many cases people can take care of their minor ailments, reducing the number of GP consultations and enabling GPs to focus on caring for higher risk patients, such as those with comorbidities, the very young and elderly, managing long-term conditions and providing new services.
More cost-effective use of stretched NHS resources allows money to be spent where it’s most needed and improve health outcomes. Furthermore, increased personal responsibility around healthcare helps improve people’s health and wellbeing and better manage long-term conditions when they do develop. This will ultimately ensure the long-term sustainability of the NHS.
Around 80% of all care in the UK is self care. The majority of people feel comfortable managing everyday minor ailments like coughs and colds themselves; particularly when they feel confident in recognising the symptoms and have successfully treated using an over-the-counter (OTC) medicine before.
On average, people in the UK experience nearly four symptoms every fortnight, the three commonest being feeling tired/run down, headaches and joint pain and most of these are managed in the community without people seeking professional healthcare.
What happens when people give up on self-care?
Despite people’s willingness to initially self-treat, there are still 57 million GP consultations a year for minor ailments at a total cost to the NHS of £2 billion, which takes up, on average, an hour a day for every GP.
Research shows that people often abandon self care earlier than they need to, typically seeking the advice of a doctor within a period of 4-7 days. The main reasons for this are:
• Lack of confidence in understanding the normal progress of symptoms (e.g. a cold can last up to 14 days)
• The perceived severity and duration of symptoms
• Reassurance that nothing more serious is wrong
• A prescription to ‘cure’ the illness, even though the same medicine may be available over-the-counter
Often just simple changes aimed at meeting the needs of local communities can be very effective at encouraging increased self care. These include giving patients the information they need to care for their common ailments and to make healthy lifestyle choices, signposting people to the right local services and outreach work to provide health advice in non-traditional settings such as pubs, libraries and job centres.
In the GP consultation itself, involving patients in their care through shared decision making has also proved to be a successful approach. This has led the Royal College of General Practitioners (RCGP) to develop a free online learning module on ‘self care for minor ailments’ which is aimed at developing GP and nurse consultation skills to support self care for patients (please see “resources” button).
Self care has progressively gained widespread support from healthcare professionals and from key organisations in primary care. More than nine out of ten GPs also now believe that self care by patients has an important role to play in general practice. Following the launch of the report ‘Self care: An ethical imperative’ in 2010, momentum for the campaign grew which led to the inception of the Self Care Forum in 2011. NHS England is a partner in the Forum, as are a number of eminent GPs and organisations including the Royal College of Nursing (RCN) and the National Association for Patient Participation (NAPP). The purpose of the Forum is to further the reach of self care and embed it into everyday life.
Self Care and the NHS Mandate1
Progressing self care is crucial and is seen by the Self Care Forum (SCF) as a significant solution towards achieving a sustainable health system.
The Self Care Forum believes the NHS Mandate should be seen as a blueprint for the integration of self care throughout the NHS. We believe that there needs to be a whole systems approach to delivering care and for this to be successful there must be an inclusion of opportunities to self care. Self Care is not something to be added once everything else has been put in place. Indeed, the NHS must support people to self care at every appropriate contact.