Self care: part one - Why GPs must invest in self care

In the first part of a series on self-care, Dr Beth McCarron-Nash examines the role of the GP.

Given appropriate support and information, patients with many minor ailments can self-care
Given appropriate support and information, patients with many minor ailments can self-care

If you face every day with a full to bursting appointments list, leaving you with the feeling that you are never going to get on top of things, you are far from alone.

Patient demand for GP appointments has doubled since 2004, according to BMA workload surveys.

A recent poll by the RCGP demonstrates spiralling GP workload, with 71% of GPs expecting appointment waiting times to become much longer as GPs struggle with increasingly complex care, increasing demand and declining funding.

The difficult part about self-care is getting GPs even to think about where to start on advising patients about it. Not all GPs are enthusiasts, but general practice has never been so stretched and GPs so demoralised. GPs tend to think self-care is all very well in theory, but they do not have the time to implement it.

How to promote self care
  • Offer a range of free resources
  • Display minor ailment tips and advice in the waiting room
  • Offer patients free minor ailment factsheets
  • Use the practice website to host self-care information
  • Inform patients about the benefits of using a community pharmacy
  • Inform patients about self-care for minor ailments such as diarrhoea, first aid, and coughs and colds

Implementing self care

Self-care is on the radar because it is one way to help reduce demand and, consequently, workload.

Among the arguments now being raised is the need to implement and fund a national self-care strategy, including patient education and awareness campaigns, as well as pushing to ensure commissioners include funding self-care support when commissioning pathways.

The recent NHS England report, Sustainable, Resilient, Healthy People & Places: A Sustainable Development Strategy for the NHS, Public Health and Social Care System, cites self-care as likely to produce 'economically sustainable solutions'.

Spelling out the prize on offer to self-care adopters, the report says: 'Every contact and every decision taken across the health and care system can help build the immediate and longer term benefits of helping people to be well and reduce their care needs.'

At my practice, the Lander Medical Practice in Truro, Cornwall, we are promoting self-care as a way to help manage demand for appointments and to empower patients.

As a negotiating team, we can push for national funding to support self-care, but it helps our lobby if individual practices and GPs also support their patients now, with a range of free resources.

Self Care Forum
  • The Self Care Forum (www.selfcareforum.org) offers a wide range of information.
  • This includes top tips, how-to guides, best practice case studies and access to the RCGP self-care course.
  • The site also provides policy background, such as the Mandate for Self Care.

Self care in practice

At the Lander Medical Practice, we display minor ailment top tips and advice about when to access different NHS resources for different conditions, on our waiting room TV screens and posters.

At the reception desk, patients can also pick up copies of the Self Care Forum's minor ailment factsheets, which can be downloaded from the website, offering information about self-management of common minor ailments and red flags.

We also use our practice website to host information for patients on the GP workload implications of minor illness, the benefits of using a community pharmacy, and correct treatment pathways for minor ailments such as diarrhoea, first aid, and coughs and colds.

To take things up a level, prescribing audits, particularly of antibiotics, are established to help embed a self-care psyche across the practice.

Self-care can also be embedded into other GP services - an example at our practice is the acute neck and back pain clinic, which is run by a physiotherapist, where self-care forms part of the management.

We are also active about good practice reminders, auditing and highlighting the prescribing indications of certain antibiotics.

Lander Medical Practice GPs have personal lists, which means my patients feel more involved in optimising their own health and know when to seek help, and I have a personal incentive to reduce my workload and manage my prescribing.

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

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