Comment

Are we doing enough to accelerate self-care?

Dr Selwyn Hodge, co-chair of the Self Care Forum, makes the case for the further reach of self-care, and for it to be embedded into our everyday lives.

Having worked for many years to get self-care accepted as a legitimate and valuable part of the national healthcare scene, it should have made me very happy to see the term being bandied about so much in the British press these days.

Sadly, it didn’t! There still appears to be no real acceptance across the country about what a workable self-care model should look like, or how behaviour changes can be accelerated to ensure a healthier 21^st-century population.

The discussion to date has been centred too much around how to get people – when they reach more advanced years, or are dealing with debilitating conditions – to look after themselves better and to cope without having to make too many demands on our already overpressurised NHS and care systems. While this is laudable, the solutions provided seem to depend entirely on the efforts of hard-pressed GPs and district nurses, supported, if overstretched budgets allow, by personalised care assistants.

We still have not developed strategies for helping people to prepare adequately for any circumstances in which they might need specialist care, or are forced to support themselves to a greater extent. As a result, we lurch from health crisis to health crisis as budgets become decimated by uncontrollable, and often unregulated, demands.

Why is this? Mainly because we have no generic cradle-to-grave system that prepares people for their future lives, builds upon a proper basis of cross-disciplinary approaches to wellness, and establishes positive joined-up attitudes to individualised self-care and the creation of national arrangements for health improvement and maintenance.

This also must be considered alongside the current national situation, where, increasingly, concern is expressed by the media about the relentless worsening in many aspects of our country’s health statistics.

One such news story, for instance, was brought about by recent research from the World Health Organization, which found that the UK is the “third fattest in Europe.”

The outcomes of depressing statistics like this are wide-ranging, but critically they are often accompanied by increasingly unnecessary visits to hospitals and GPs for simple, easily treatable conditions, which are then often further exacerbated by the individual’s unchanged behaviours – leading to chronic disease patterns and further time-consuming consultations.

So, the question must be asked: are we unwilling to take more responsibility for our own health outcomes because we’d rather someone else do it for us, or because we don’t know how?

Although parts of this scenario might reflect a small proportion of the population unwilling or unable to protect their own health, it is undoubtedly a fast-growing concern and, noticeably, is accompanied by ever-declining health literacy levels, demonstrating that matters are getting worse.

As a nation, we seem to be sleepwalking towards a future of poorer health and even poorer health literacy, which will undoubtedly escalate all the tensions around current healthcare provision. Critically, we risk leaving the door open to the reintroduction of medical conditions that were once considered defeated – something we are already observing in other countries.

Earlier this month during Self Care Week (12-18 November), health providers and commissioners came together, having honed their own localised care plans, to better tackle not only potential lifestyle crises, but also self-care for short-term and long-term conditions. There were also collaborations with local schools to communicate self-care messages to students, schoolchildren and parents, all of which was key to increasing local health literacy levels and therefore to improving the health and wellbeing of future generations.

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