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What is self-care?
The Self-Care Forum’s definition of self-care is:
Self-care is part of everything we do, every day, for ourselves and for others [i]. represents the bulk of healthcare (World Health Organisation, 1983[ii]). It is often influenced by upbringing, beliefs and contacts with other people. Most self-care takes place without direct involvement from healthcare professionals, although professional support becomes increasingly important as health needs become more complex.
The Self-Care Continuum illustrates this progression, from complete personal responsibility for health and wellbeing on the left through to conditions requiring intensive professional intervention on the right[iii].
The Self-Care Continuum
As people move along the continuum from left to right, self-care remains important, but the level of professional support increases.
The continuum includes:
- Wellness – focusing on positive good health rather than on illness and disease[iv].
- Wellbeing – feeling good and functioning well, helped by experiencing positive relationships, having some control over our lives and having a sense of purpose[v].
- Lifestyle, prevention and health promotion – making informed daily choices to live as healthily as possible, reduce the risk of developing diseases and of dying early[vi], taking individual responsibility for our health, including healthy eating, physical activity, oral health, sun protection and other actions that reduce the risk of disease[vii]. Support from professionals, including pharmacists and social prescribers can help.
- Self-limiting conditions – managing common problems such as sore throats, headaches, heartburn and other symptoms, which can often impact our daily lives (which is why we do not use the term ‘minor’), but can usually be managed safely with self-care and over-the-counter treatments[viii]. The Self-Care Forum’s website[ix] and the NHS’s website[x] are a great place to start.
- Self-managed healthcare[xi] – this covers the increasing use of digital tools, apps and wearables to support evidence-based health and condition management.
- Long-term conditions (LTCs) – these conditions, such as asthma, diabetes, heart disease and high blood pressure, require ongoing management support and periodic professional review[xii]. People with a long-term condition can spend on average 4 hours a year with a health professional, which means the remaining 8756 (99%) hours are spent self-managing[xiii].
- Acute illness and major trauma – conditions needing mainly professional intervention up to “major trauma” where responsibility for care is often entirely in the hands of professionals. Even when professional care is required, the needs, beliefs and choices of the individual must be considered and supporting people to regain confidence and independence through self-care remains important.
Self-care is not no care. The NHS has a role in supporting self-care at every stage of the continuum.
Why is self-care good for people?
Self-care helps people gain greater control over their health and encourages behaviours that improve wellbeing and prevent illness. This can lead to longer, healthier and more fulfilling lives.
For people with long-term conditions, effective self-management can improve quality and length of life and health outcomes. Since individuals with LTCs spend only a small fraction of their time with healthcare professionals, most care is delivered through day-to-day self-management.
In many cases people can take care of their common conditions, reducing the number of surgery visits enabling health professionals to focus on caring for higher risk patients, such as those with co-morbidities, the very young and the elderly.
More cost-effective use of stretched NHS resources allows money to be spent where it’s most needed, helping to secure better health outcomes in the population.
This will ultimately ensure the long-term sustainability of the NHS.
Why is self-care good for the NHS?
Better self-care can reduce avoidable visits to GP practices, urgent care services and emergency departments, enabling health professionals to focus on patients with more complex needs.
By helping people prevent illness, manage common conditions and live well with long-term conditions, self-care makes more effective use of NHS resources and supports better population health outcomes.
In 2002 the UK Treasury concluded that the long-term sustainability of the NHS depends on people being active participants in maintaining and managing their own health, supported by reliable information and evidence-based advice[xiv].
Ways health professionals can help to change behaviour
Often just simple changes aimed at meeting the needs of local communities can be very effective at encouraging increased self-care.
These include giving service-users 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.
During NHS interactions, involving service-users in their care through shared decision making is considered a successful approach. And, the Self-Care Forum’s self-care fact sheets were produced with this in mind, helping health professionals empower people during consultations.
Also advisable is getting involved in national awareness events such as No Smoking Day, Men’s Health Week, Self-Care Week, Know Your Numbers Week. This can help to bring attention to ways people can help themselves take better care of their physical health and mental wellbeing.
References
[1] WHO World Health Organization (2009). The Ottawa Charter for Health Promotion 1986. Published in Milestones in health promotion : statements from global conferences. World Health Organization. World Health Organization. https://iris.who.int/handle/10665/70578
[1] WHO World Health Organization. Health Education Service (1984). Health education in self-care : possibilities and limitations. World Health Organization. World Health Organization. https://iris.who.int/handle/10665/70092
[1] Smith, P in: AESGP: The association of the European self-medication industry 40th annual meeting – Self-care in an enlarged Europe – more benefits for more people; Conference report, Madrid, 2–4 June 2004.
[1] Dunn H High Level Wellness for Man and Society 1956 : American Journal of Public Health VOL. 49. NO. 6. amjphnation00322-0058.pdf
[1] New Economics Foundation on behalf of the NHS: Five ways to wellbeing. 2009. https://new-economicsf.files.svdcdn.com/production/files/five-ways-to-wellbeing-1.pdf?dm=1584709195
[1] World Health Organization. Regional Office for Europe (1999). Healthy living : what is a healthy lifestyle?. Copenhagen : WHO Regional Office for Europe. https://iris.who.int/handle/10665/108180
[1] Lippman D, Stump M, Veazey E, Guimarães ST, Rosenfeld R, Kelly JH, Ornish D, Katz DL. Foundations of Lifestyle Medicine and its Evolution. Mayo Clin Proc Innov Qual Outcomes. 2024 Jan 20;8(1):97-111. doi: 10.1016/j.mayocpiqo.2023.11.004. PMID: 38304165; PMCID: PMC10831813.
[1] Austen El-Osta, Sami Altalib, Mahmoud Al Ammouri, Peter Smith Understanding Demographic Disparities and Personal Barriers to Self-Care in the UK: Findings from the Living Self-Care Survey Study
medRxiv 2025.06.01.25328757; doi: https://doi.org/10.1101/2025.06.01.25328757
[1] Self-Care Forum Factsheets https://www.selfcareforum.org/fact-sheets/ SCF
[1] NHS Conditions A to Z – NHS
[1] El-Osta A, Rowe C, Majeed A. Developing a shared definition of self-driven healthcare to enhance the current healthcare delivery paradigm. J R Soc Med. 2022 Nov;115(11):424-428. doi: 10.1177/01410768221136245. PMID: 36455623; PMCID: PMC9723810.
[1] Valabhji J, Barron E, Pratt A, et al. Prevalence of multiple long-term conditions (multimorbidity) in England: a whole population study of over 60 million people. Journal of the Royal Society of M edicine. 2024;117(3):104-117. doi:10.1177/01410768231206033
[1] Department of Health (2005) Self Care – A Real Choice Self Care Support – A Practical Option https://webarchive.nationalarchives.gov.uk/ukgwa/20130107105354/http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4101702.pdf
[1] Wanless D, for HM Treasury (2002): Securing Our Future Health: Taking A Long-Term View. Available at:
https://www.yearofcare.co.uk/wp-content/uploads/2024/07/Wanless.pdf