GPC negotiator Dr Beth McCarron-Nash: Time for the NHS to promote self-care

The recent Healthwatch report on the pressures facing emergency care reopened the debate about the challenges confronting key parts of the NHS.

One particular aspect caught my eye: one in five patients admitted that they had visited A&E when they didn't feel they needed to.

It would be easy to use this evidence to berate the 'worried well' for putting unnecessary pressure on services. But in truth, it demonstrates that patients often do not have the right information to judge where, or if, they should seek NHS treatment.

Promoting self-care is not something the NHS has ever done very well. Patients often do not know what their options are when they fall ill.

The impact of this information gap is not trivial. By failing to give patients the information they need, the NHS is generating unnecessary work, affecting general practice as much as A&E.

GPs conduct 340m consultations a year. But how many of these could be avoided with a sound self-care programme for patients?

Politicians of all colours are continuing to push for the NHS to do more and more, but are not delivering the resources needed to support their aspirations. This has been felt most keenly in general practice, where we are told GPs must provide 'any time, any place, anywhere' access and a raft of other new services - in a climate of falling resources, rising workload and no funding for extra GPs. This illogical approach is raising public expectations without giving GPs the ability to satisfy the resulting demand.

There should be renewed government emphasis on self-care. As well as pushing for funding to support a comprehensive self-care programme, we need to make practices and GPs aware of what is available now, including the range of free resources that anyone can access.

There are no easy answers to dealing with the workload pressures facing the NHS and any effort needs to be co-ordinated, multifaceted and holistic. But a good starting point would be to focus on patients' own assessment of what care they need and to encourage them to use finite NHS resources appropriately. We can't afford not to.

  • Dr McCarron-Nash is a GPC negotiator and a GP in Truro, Cornwall.

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