A coalition including NHS Clinical Commissioners, the Royal College of Nursing and PAGB, the consumer healthcare association, is calling for a co-ordinated policy drive to improve understanding of self-treatable health conditions and support self care options.
Setting out its proposals in a new paper, “Realising the potential: Developing a blueprint for a self care strategy for England”, the group – which also includes the National Pharmacy Association, the Self Care Forum, the Company Chemists Association, the Royal Pharmaceutical Society, the National Association of Primary Care and the Association of Independent Multiple Pharmacies – says: “Despite the widely recognised benefits of self care, there are numerous barriers to maximising the opportunities it presents: rigid patient pathways, unnecessary prescribing habits and persevering perceptions of hierarchies in the NHS all stifle progress.”
Recommending a raft of measures to bring about ‘a wholesale cultural shift’ in attitudes towards self care and accessing health services, it says:
• The Department of Health and Social Care should work with medicines regulators to identify conditions for which treatments could be switched from prescription-only (POM) to over-the-counter (OTC) status, to give people faster, easier access to medicines and promote self care;
• Pharmacists should be more fully integrated into the health system, with the right to update as well as read individuals’ medical records;
• Pharmacists should have the right to refer people directly to other healthcare professionals, so that anyone visiting a pharmacy as a first option knows it will lead them either to the best self care advice or to another appropriate expert.
The blueprint says self care should be taught in primary and secondary schools and included in healthcare professionals’ training curricula.
It also urges policymakers to use digital technology ‘to its full potential’ as a way of broadening access to self care information and supporting self-treatment options.
The group says the COVID-19 pandemic prompted a shift in attitudes as people followed Government advice to self care wherever possible. This offers a ‘unique opportunity’ to embed self care fully into the NHS, freeing up resources such as GP appointments and A&E slots for those who need them most.
However, it warns: “[I]f the system allows people to return to pre-pandemic behaviours, this opportunity will be lost and the avoidable demand of treating self-treatable conditions will continue to be felt in primary and urgent care settings throughout the NHS.”
In 2020, a PAGB survey found that 69% of people who would not previously have considered self care said they would do so after the pandemic. In a similar survey in June 2021, that figure had fallen to 54%.
Michelle Riddalls, Chief Executive of PAGB, said:
“Self care is a vital part of our health system. It has the potential to reduce health inequalities, improve outcomes and protect NHS resources for those who need them most.
“However, too often it goes unrecognised by policymakers.
“A national self care strategy, as envisaged in this blueprint drawn up by a broad range of healthcare and pharmacy organisations, would bring significant benefits for individuals as well as on the NHS as a whole.
“We look forward to working further with stakeholders and the Government towards this goal.”
GP Dr Sarah Jarvis said:
“Self care is a valuable life skill which makes a real and positive difference to the way people are able to navigate common minor health problems.
“The pandemic, and the pressures on the NHS which persist as a result, have highlighted the need for all of us to understand when and how self care is appropriate.
“There is a clear desire among the public to practise self care in order to help themselves and relieve pressure on the NHS – but they need to feel able and supported to self care when that’s the best option for them.
“We need to empower individuals to recognise and manage self-treatable symptoms quickly and effectively, with advice from a pharmacist where necessary but without the need for a GP consultation.
“Embedding the role of the pharmacist as a key and integral part of the primary healthcare team can empower patients and make the best use of the invaluable skills of our community pharmacy colleagues. This blueprint for a national self care strategy recognises the urgent need to make the best use of the resources available to us by incorporating an enhanced role for pharmacists.
“I very much hope the blueprint will attract the support it deserves across the NHS and beyond, and that those projects already operating to support and encourage self care can serve as inspiration for a more systematic approach.”
PAGB President Neil Lister said:
“Self care is not ‘no care’. It is an important but often overlooked part of the primary care pathway.
“Prior to the COVID-19 pandemic, there were 18 million GP appointments and 3.7 million visits to A&E for self-treatable conditions, which could have been managed at home with support and advice from a pharmacist.
“Over the last 18 months, the COVID-19 ‘stay at home’ message has shown people that they can self care for minor ailments. We need to enable them to continue to do so now the restrictions have eased.”