In both the NHS Five Year Forward View and Long Term Plan, self-care rightly gets a piece of the pie.
For instance, the former states that ‘many (but not all) people wish to be more informed and involved with their own care, challenging the traditional divide between patients and professionals, and offering opportunities for better health through increased prevention and supported self-care’.
Indeed, it’s argued that the future of a viable, affordable and efficient NHS depends on safely and effectively supporting and enabling increased levels of appropriate self-care for large cohorts of patients.
In its current form, the NHS simply isn’t clinically and financially viable, largely thanks to the ever-increasing demands and expenses it incurs. And while this is already overwhelming, it’s likely to only increase with an ageing and expanding population, multi-morbidities following suit.
When broaching the broad topic of self-care, it helps to fall back on a definition or theory about the specific context in which it’s being discussed. The Self-Care Forum promulgated ‘The Continuum of Self-Care’, a concept that indicates how individual usage of self-care fluctuates greatly.
It’s argued that the future of a viable NHS depends on safely and effectively supporting and enabling increased levels of self-care for large cohorts
According to this continuum, self-care ranges from being complete, or ‘pure’, such as via self-management of minor ailments like the common cold, to complete or ‘pure’ professional care, in the trauma of severe traffic accidents, for example.
Throughout their lifetimes, individuals will engage with their health status for wildly different reasons – from daily lifestyle choices to the occasions requiring complete professional responsibility, whether having surgery or being sectioned under the Mental Health Act. Therefore, this continuum is a useful tool for navigating the spectrum of emotions and responses that ensue.
Over the last few decades, one of the factors that has led to the seemingly near-endless demand of NHS resources and appointments is a generalised societal shift. This change in public behaviour leans towards the right side of the continuum, with increasing professional care and responsibility in self-care of areas such as:
- Self-limiting illness
- Long-term chronic conditions in an ageing population with increasing multi-morbidities
- Possible problems with over-medicalisation and over-diagnosis
- Mental and psychological health and wellbeing
If promoted among community groups and applied correctly, self-care could help lessen the collective strain on NHS services. With this in mind, Imperial College London’s Department of Primary Care and Public Health established the Self-Care Academic Research Unit (SCARU).
Set up in alliance with the Self Care Forum and International Self Care Foundation, SCARU is the first academic unit in the world that studies self-care to this extent. It recently published its first paper, on the Self-Care Matrix as a tool and method of analysing self-care ideas and interventions.
Given the volume of interest in self-care, both nationally and further afield, there is a particular emphasis on ageing and multi-morbidities; coping with demands on healthcare systems; improving patient empowerment and health literacy; and supporting people to proactively lead healthy lives, SCARU aim to occupy the forefront of the efforts moving forwards.
Dr David Mummery is a GP in west London and academic clinical research fellow at Imperial College London
For more information about SCARU, please visit here.