GUEST EDITORIAL
Supporting self-care in the 21st century – a long-term (conditions) view David Colin-Thomé National clinical director for primary care, Department of Health
My commitment to healthcare reform and support for self-care are derived from three personal beliefs which have been further shaped by my experience of working as a GP in an underprivileged area for some 36 years.The public and individual patients need to have far more influence on the NHS and their personal care, the ideal clinical consultation should be a ‘meeting of two experts’. I am hugely proud of the NHS for its role in promoting social justice but there is far too much ‘unwarranted’ variation in the quality of access and care. Reform and empowerment are the necessary catalysts for culture change and service improvement.
The policy context There are more than 15 million people in England living with a long-term condition and this number is expected to double by 2030. The NHS and an increasing number of alternative providers support people through excellent clinical care every day, but people say they want to do more for themselves – as long as they get the right support. We know that better-informed people achieve better health and quality of life. They are more confident and better prepared to manage changes in their condition. People with long-term conditions are experts in how their conditions affect them and their lives. But being an active participant in improving your health and wellbeing is not always easy and can prove quite a challenge if feeling ill and vulnerable. In these circumstances, people often need the additional support of their clinicians as well as their family and friends.
care planning should incorporate many aspects of a person’s health and wellbeing, including looking after body, spirit and mind. The process will involve input from a multi-disciplinary team of professionals, but most importantly features a relationship between the person themselves and their key worker which in healthcare is usually a clinician. Ideally the key worker is the choice of the individual person.
What is self-care? Self care is an integral part of daily life and is all about people taking responsibility for their own health and wellbeing, with support from and in conjunction with the people involved in their care. Self-care includes the actions people take every day in order to stay fit and maintain good physical and mental health; meet their social and psychological needs, prevent illness or accidents, and care more effectively for minor ailments and longer term conditions. (Supporting people with long term conditions to … self care, Feb 2006, DH)
Approaches to self-care support There is a range of approaches to self-care and the NHS can support people in involving them through a process of discussion, decision-making and ongoing support, as part of the care planning approach. A personalised care plan is a record of the discussion about the support and services available to help someone live with their condition, including agreed decisions, actions, goals and follow-up. Everyone with a long term condition should be offered a personalised care plan by 2010. We know that the delivery of truly personalised care for people with long-term conditions goes beyond just treating an illness. It requires a holistic approach that puts the individual at the centre of their own care. Personalised
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The importance of supporting self-care The importance of engaging people to self-care in order to better manage their long-term condition is further highlighted by research conducted by MORI.1 This revealed that only half (53%) of those surveyed took an active role in taking care of their condition ‘all of the time’, of these 51% stated that they felt comfortable in doing so. Two-thirds of those surveyed had also approached their GP, practice nurse or pharmacist within a six-month period seeking self-care advice and information, reinforcing the need for a more personalised approach to care.
© Journal of holistic healthcare
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Volume 6 Issue 2 Aug 2009
