The Pharmaceutical Journal
Vol 273 No 7324 p695
6 November 2004

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Proprietary Association of Great Britain

Self-care key to Government’s vision

Self-care is one of the key pillars in the Government’s strategy for health in the 21st century, according to health minister, Lord Warner.

Outlining the Government’s approach to self-care, he said: “Self-care is central to our wider vision of choice in health. We are determined to enable people to make real choices about their health, their treatment and their care. We want health professionals to help people to make those choices and, as important, to ensure that their choice is fulfilled.”

He told delegates that self-care was included in several Government strategy documents and programmes: the NHS Improvement Plan; the new national standards; the programme for managing long-term conditions; the new pharmacy contract; the public health consultation; and the imminent Information for Choice strategy.

“These are big-ticket programmes that cover the whole spectrum of care and millions of people, but which all have self-care as key themes. I want to see self-care embedded in service delivery. This has begun with the expert patient programme. There is more to come on long-term conditions, public health and information.”

He also confirmed that plans to extend independent prescribing rights to pharmacists are on course and should be in place by the end of 2005.

“We are now beginning discussions on the development of a framework for independent prescribing by pharmacists. We expect to have independent prescribing for pharmacists in place by the end of 2005. These developments are playing an important part in delivering greater choice, better access and higher quality care for patients.”

Health care professionals need to deliver consistent messages

If the Government’s self-care agenda is to be taken forward health care professionals must learn to give consistent messages to people with long-term conditions.

Mike Pringle, professor of general practice at the University of Nottingham, warned that patients had a right to expect high quality information and that if they heard inconsistent messages from different health care professionals they would stop listening.

He pointed out that people with diabetes spend, on average, just three hours each year in consultation with their GP or hospital specialist. For the rest of the year patients would be making choices about the management of their condition themselves.

“We need to make those three hours as empowering as possible so they can make the right choices,” he said, adding that health professionals must stop fooling themselves that they can make decisions for patients. He also said that pharmacists need to be integrated into the primary care team so they, too, deliver the same messages to patients. “Research tells us that we can change behaviour if the same message comes from three different sources.”

Professor Pringle went on to outline a pilot project being conducted within Erewash Primary Care Trust in Derbyshire to test whether a programme of self-care could be integrated into service delivery. “The project is trying to develop a self-care culture, a step change in awareness. If we give people the tools to make decisions and take control will there be a knock-on effect to better self care and better health-seeking behaviour,” he said.

A review of the Erewash PCT self-care pilot project will appear in The Journal shortly.

Role for pharmacists as case managers

Community pharmacists could act as case managers for people with long-term conditions, according to David Colin-Thomé, the Government’s national clinical director for primary care.

Dr Colin-Thomé was commenting on the newly created role of community matron and said that nurses, probably district nurses, would take this on. But he added that there would be a need for more case managers for people with long-term conditions. “Community pharmacists could fill that role,” he said. He explained that the Government wanted health care professionals to focus on the care of individual patients. “Ultimately, we do not care who does it, as long as they have the appropriate skills,” he said.

Health information at work may encourage men to seek advice

Informal approaches to the way information and advice is offered to men may help them change their health-seeking behaviour.

Peter Baker, director of the Men’s Health Forum, said that men would use health services if they were delivered in the right way. He suggested that offering advice and information within the workplace may encourage men to seek help and could lead to a more effective use of pharmacy services.

A pilot study conducted by researchers at Bournmouth University on behalf of the PAGB and the Men’s Health Forum, showed that men were happy to discuss health issues at work. Men were questioned about their health-seeking behaviour in relation to indigestion and views were sought about a leaflet designed to increase men’s awareness of the condition.

The researchers found that most men turned to over-the-counter medicines to treat indigestion and did not consider changing their lifestyle. However, use of the leaflet helped increase knowledge and positive changes in health behaviour were reported by 21 per cent of the 200 men who responded. The changes were maintained for six months in 14 per cent of the sample.