The government needs to develop a national self care strategy, with community pharmacy playing a central role, to steer people away from unnecessary GP and hospital visits, say leading healthcare and industry bodies.
The strategy will not only ease the pressure on the NHS which is still recovering from the Covid-19 pandemic, but also improve quality of life of the people along with longevity.
A coalition including NHS Clinical Commissioners, the Royal College of Nursing and PAGB, the consumer healthcare association, has called for a co-ordinated policy drive to improve understanding of self-treatable health conditions and support self care options.
The group also includes the National Pharmacy Association, the Self Care Forum, the Company Chemists Association, the Royal Pharmaceutical Society, the National Association of Primary Care and the Association of Independent Multiple Pharmacies.
Setting out its proposals in a new paper, “Realising the potential: Developing a blueprint for a self care strategy for England”, the group says: “Despite the widely recognised benefits of self care, there are numerous barriers to maximising the opportunities it presents: rigid patient pathways, unnecessary prescribing habits and persevering perceptions of hierarchies in the NHS all stifle progress.
Recommending a raft of measures to bring about ‘a wholesale cultural shift’ in attitudes towards self care and accessing health services, it says:
- Pharmacists should be more fully integrated into the health system, with the right to update as well as read individuals’ medical records;
- Pharmacists should have the right to refer people directly to other healthcare professionals, so that anyone visiting a pharmacy as a first option knows it will lead them either to the best self care advice or to another appropriate expert.
Expressing her support for the blueprint proposal, Helga Mangion, policy manager at the NPA said: “We support these proposals, which acknowledge that community pharmacy will need to be front and centre of any serious effort to boost self-care.
“As the front door to the NHS, community pharmacy is an essential element of whole-systems support for self care, leading to better health outcomes and improved quality of life.”
She reminded of the NHS long term plan which highlights the role of pharmacy in the prevention and management of long term conditions.
The chapter two of the paper talks about the same – referral as advice and support within the pharmacy go hand in hand.
Mangion added that setting up a link or a proper channel amongst all health and social care colleagues is going to be absolutely vital for health care system working.
"Making better use of the technology and the communications, so that the community pharmacists can refer people directly into other healthcare professionals, as appropriate.
"At the moment, is just the other way around but we got to have a two-way process, a fully integrated primary care network that includes community pharmacy involvement as a standard."
Self care training
The blueprint further recommends teaching self care in primary and secondary schools and its inclusion in healthcare professionals’ training curricula.
Dr Peter Smith, president of the Self Care Forum Board said: “Catching the adult is often too late. Health literacy should be embedded in learning and both primary and secondary school level, and students should be equipped with the knowledge to self care, self treatable problems at the very least.”
Currently, understanding of health literacy is optional in professional training.
Smith said for continued professional development and flow of opportunities, training on self care and health literacy should be made available to all health professionals including pharmacists throughout their careers.
Go digital
The group has also urged the policymakers to use digital technology ‘to its full potential’ to broaden access to self care information and supporting self-treatment options.
Stephen Goundry Smith, pharmacist and consultant at SGS PharmaSolutions said: “The right digital systems in the background, could help to provide the necessary knowledge to encourage stakeholders in our health service to move to a culture of self care”
He highlighted the issue of “digital divide”, where in a region 20 per cent of citizens do not have access to the internet, or a smartphone.
He added such “technological barriers can be offset by community pharmacies, acting as a self care (provider), given their unparalleled accessibility as a service, and the experiences.”
Community pharmacies can play a big role in setting up self care hubs.
Though, community pharmacist consultation service (CPCS) is already in place, there is a need to increase referrals to community pharmacies, and referrals can be made out from there to other services when necessary and appropriate, he added.
Advocating giving access of care records to community pharmacies, he said: “Access to the summary care record has been very beneficial for the professional activity of community pharmacies.”
Smith said their ability to write to care records will ensure that self care facilitated by community pharmacy is recorded, and brought to the attention of other care providers.
Health inequalities
Self care, a vital part of our health system, has potential to reduce health inequalities, said Michelle Riddalls, chief executive of PAGB.
“However, too often it goes unrecognised by policymakers.
“A national self care strategy, as envisaged in this blueprint drawn up by a broad range of healthcare and pharmacy organisations, would bring significant benefits for individuals as well as on the NHS as a whole.
The group noted that the pandemic has instilled a clear desire in the people to learn about self care. This offers a ‘unique opportunity’ to embed self care fully into the NHS, freeing up resources such as GP appointments and A&E slots for those who need them most.
GP Dr Sarah Jarvis said: “Embedding the role of the pharmacist as a key and integral part of the primary healthcare team can empower patients and make the best use of the invaluable skills of our community pharmacy colleagues.
“This blueprint for a national self care strategy recognises the urgent need to make the best use of the resources available to us by incorporating an enhanced role for pharmacists.”
PAGB president Neil Lister noted that prior to the pandemic there were almost 18 million GP appointments and 3.7 million visits to A&E for self-treatable conditions. These conditions could have been easily managed through self care at home or with advice from a pharmacist.
“Over the last 18 months, the Covid-19 ‘stay at home’ message has shown people that they can self care for minor ailments. We need to enable them to continue to do so now the restrictions have eased.”
