Dr Graham Jackson
GP and Co-Chair of NHS Clinical Commissioners
Encouraging self-care for certain minor ear, nose and throat conditions has the potential to improve care for patients, writes Dr Graham Jackson, co-chair of NHS Clinical Commissioners.
Self-care refers to the steps people can take to develop, protect, maintain and improve their own health and wellbeing and has a really important role to play in health promotion and illness prevention. Many common ear, nose and throat conditions are suitable for self-care, and at NHS Clinical Commissioners (NHSCC), we place great importance on encouraging medical professionals to promote the benefits of self-care to their patients and the populations they serve.
For clinical commissioners like me, the priority is getting the best possible care for patients in the context of the NHS’s finite resources. Part of that is making the most of the resources that we do have. Appropriate self-care can play an important role in helping commissioners get the best value for taxpayers’ money from the NHS.
NHSCC has been working with NHS England on behalf of its members to develop new commissioning guidance for over-the-counter items that should not routinely be prescribed in primary care. This guidance, published in March 2018, applies to conditions that are self-limiting, which do not need treatment, such as acute sore throat, coughs and colds, or which are better suited to self-care, like hay fever or a build-up of earwax, which can often be treated with easily available over-the-counter products.
This initiative alone is already releasing a significant amount of money, which can instead be spent on higher priority areas and has the potential to release even more funds to be re-invested in other areas of the NHS
Clinicians must support patients to self-care
The shift to self-care for certain conditions doesn’t mean we leave patients to go it alone, but we do need to abandon the outdated, paternalistic approach that has led to the current situation of over potentially over-medicalising self-limiting conditions.
It is important to get the balance right; when people seek help from healthcare professionals it is appropriate to advise patients regarding self-care options to encourage that independent behaviour. It is well recognised that the NHS can be difficult to navigate, which makes it confusing for people to know where to go for advice. Simplifying access to care and directing patients to supported self-care go hand-in-hand to making the system more efficient and effective for the population it serves.
Encouraging self-care, with support, will educate and empower the population to make better decisions about their own health, which means they can, in turn, help others to help themselves. It also gives people the confidence to know when self-care isn’t enough, and that sometimes doing nothing – to wait and see – is the right course of action.
It’s also important to acknowledge that this can be difficult for some people, which is why it’s so important to have accessible, usable and free resources – such as those available from the Self Care Forum and the NHS Choices website.
When it comes to self-care for ear, nose and throat
conditions, a bathroom cabinet that’s well stocked with over-the-counter
products is important, but it is much more than that. Small lifestyle factors
like exercising or getting enough sleep – as well as more significant changes
like giving up smoking – can help prevent these conditions in the first place
and help the body to recover from illness more quickly. Health promotion and
illness prevention should always be seen as best practice.