Invest to save: encouraging self-care awareness in GPs

Even with the best self-care policy, GPs can run into the problem of maintaining enthusiasm. Dr Beth McCarron-Nash advises on avoiding the common pitfalls in self-care practice.

Educating patients to feel confident to self care is essential (Photo: JH Lancy)
Educating patients to feel confident to self care is essential (Photo: JH Lancy)

It can be difficult to get GPs even to think about self-care. Not all GPs are enthusiasts and general practice has never been so busy or GPs so demoralised. Some GPs may think they do not have the time for self-care. But we should make the time for this: it's all about investing to save.

However, even in the most self-care aware practice, enthusiasm can flag over time, so it is important to find ways to keep up the impetus.

Giving patients information

Patients know antibiotics do not work in cold and flu infections - they have seen the campaigns and they know their GP will not normally prescribe them - but they still make an appointment.

This is often because they have tried self-care but they think it has not worked. It often is working or will work, if only the patients give it a bit longer.

If you can educate patients about what is normal for a particular minor ailment, such as the range and duration of symptoms and when they need to seek help, they are much more likely to feel empowered and to self-care. The Self Care Forum has a library of free resources and factsheets that offer advice on what is 'normal' for a range of minor ailments. They are GP-validated and very popular.

How to motivate GPs about self-care
  • Use prescribing audits to promote a sense of competition
  • Implement named or usual GP lists - successful self-care messaging will directly benefit an individual GP's or practice's workload
  • Involve your patient participation group
  • Run an annual self-care awareness week or educational events to empower patients

Validating illness

Patients also come to the GP seeking validation that they are ill and for many, this validation takes the form of a prescription, usually for antibiotics. But people can get the validation they seek through a prescription for self-care. This consists of written health information and relevant self-care tips that the patient can take away. It may help to support this with a verbal hug. You could say to the patient: 'I know you are really ill, but antibiotics won't work for you. Paracetamol, rest and fluids are what you need.'

Cost of GP visits

People who are entitled to free prescriptions will sometimes travel to the surgery and wait to see the doctor, even if the prescription is for a simple OTC medicine such as paracetamol. To reverse this behaviour, you might use your website or other information hubs to give the patient an idea of the actual cost of their visit, including taxi fares, parking or the cost of the petrol and mechanical wear and tear of using their own car. The more socially aware patient might also acknowledge the carbon footprint of the journey, and possibly, the cost to the NHS (and ultimately, the taxpayer) of the GP's professional fees for that consultation. Tot this up and compare it with the retail cost of a packet of an OTC generic analgesic.

Unrealistic patient expectations

The political drive for 8am-8pm, seven-days-a-week GP access stokes patient demand and is having a significant effect on GP workload. It is not patients' fault, but it is hardly a vote winner for politicians to say the NHS is not funded adequately for need, let alone for supermarket convenience. We must be honest about what the NHS and GPs can realistically deliver with finite resources. A sustainable NHS is built on a properly funded sustainable GP practice - our national negotiators and GPs recognise this, but so must patients and politicians. Politicians must stop stoking unrealistic patient demand and patients must come in to see us only when they need to, keeping as healthy as possible and self-caring when appropriate.

Involving practice staff

Consider training practice staff to take on extra or different tasks, for example, your receptionists could be co-trained in phlebotomy or as healthcare assistants. This would allow the healthcare assistants to take on extra tasks, such as giving advice about self-care, diet and lifestyle. The roles of healthcare assistants and practice nurses can be supported by a GP triage system, where patients calling the surgery for a same-day appointment are directed to the most appropriate care pathway; often, this is not just to come in to see the doctor immediately. You could involve the whole practice and encourage all staff to support patients with support from the non-medical team.

  • Dr McCarron-Nash is a GP in Truro, UK GPC negotiator and self-care advocate

Resources: Self Care Forum www.selfcareforum.org

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