SELF-C ARE AND GPs
Helping patients to help themselves Ruth Chambers GP & clinical champion for the Lifestyle Support Programme, NHS Stoke on Trent, Honorary Professor Staffordshire University
Introduction
Summary If people want to live for as long a time as their genes allow and be as healthy as possible then they have to take responsibility for their own health and wellbeing. There’s only so much the NHS can do for people with long-term health conditions: nagging and motivating them to better their lifestyle; sharing the ‘power’ of medication in jointly agreed management plans. An allround integrated approach means consistent advice, person-friendly local lifestyle services, with high ratings for everything that will help – conventional treatments, alternative therapies and personal support.
© Journal of holistic healthcare
Being a GP for 30 years and honorary professor at Staffordshire University makes me sound old and wise. But I’m still learning how to get people motivated to change their adverse lifestyle habits long-term (don’t they want to be healthy and well? We in the NHS want that for them!) as a clinical champion for the Lifestyle Support Programme of NHS Stoke on Trent. Of course we need good quality and effective services too which is where my other jobs come in – clinical champion for the PCT’s Quality Improvement Framework and clinical lead for Practice Based Commissioning.
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Volume 6 Issue 2 Aug 2009
Self-care is the individual responsibility people take in making daily choices about their lifestyle and risk taking. This may be in relation to their work, travel and hobbies, and other aspects of their everyday lives. Self-care can only work in the healthcare setting if health professionals enable people with longterm conditions to help themselves. Health professionals can only help such patients to help themselves if the local primary care organisation (PCO) has commissioned hospital and community services to support and promote self-care. And information about the availability and reliability of alternative therapies is easily accessed and well known. The often shown slide at self-care workshops describes a typical person with diabetes receiving up to three hours of care a year from health professionals, the rest being self-care. That diabetic patient needs GPs and practice nurses who encourage their self-management with a jointly agreed plan. The patient should be able to understand how to achieve good blood sugar control – through regular monitoring and probably adjustment of their prescribed treatment. They may bring home blood pressure readings to their clinical reviews at their GP’s surgery. They may actively review their weight and cut down on their food intake accordingly. There needs to be
local lifestyle services that aid weight management, good nutrition, physical activity and support people with mental health problems – maybe via one-to-one sessions with lifestyle coaches. The community or secondary services they are referred to should endeavour to encourage self-care.
Tips for practices Patient choice is only possible if people know what is available and have an understanding of how likely it is that the various treatments are applicable to them, might reasonably be expected to work, are safe and could suit them as individuals. So good patient literature, recommended websites and other sources of information are all vital, presented in a way and language that fit the person’s needs and preferences. Information is all well and good but patients often need a way of navigating patient choice, as well as the advice and guidance they receive from their health professionals. The recently established network of locally based health trainers in the NHS are one group of guides who can help individuals choose to practise self-care and opt for local lifestyle services available to them. One of the positive attributes of such health trainers is that many originate from the local community so that they have a cultural understanding of their clients.
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