Safe-care; bringing together expertise and experience in Sunderland to help people help themselves to a better life.
All Together Better Sunderland has been chosen, by the NHS England Empowring People and Communities Team, as one of fifteen ‘vanguard’ sites to focus attention on the benefits of ‘self-care’ in order to help local people take control of their own good health and wellbeing.
It is well accepted that a healthy lifestyle supports both physical and emotional health and because the vanguard is designed to concentrate efforts on a the people who need the most help and support in the city – usually those with complex conditions and the frail and elderly – All Together Better is working with a wide range of organisations and groups to ensure those people get co-ordinated support.
This will include putting in place systems that will help local health and care organisations to identify people who are most in need of self-care support, and also helping people, for example, those with long term conditions manage their condition more independently.
What is self care – read our FAQs:
What is self-care and self-management, what’s the difference?
Self-care is a broad concept, including self-management, but in essence is all about people looking after themselves in a healthy way. The term can be used to cover healthy lifestyle changes, taking medications, treating minor ailments and knowing when and how best to seek help.
Self-care can include a lot of self-help actions and decisions about how to deal with issues, such as using the pharmacy for advice on minor ailments instead of A&E or the GP; taking exercise and eating healthily; cutting down or stopping smoking and drinking or learning mindfulness techniques for stress management.
Self-care is more about prevention and early detection and depends greatly on how an individual can obtain, process and understand basic health information to make informed decision-making.
Self-management, which is about people protecting and managing health when someone has a long-term condition(s), such as heart disease, diabetes and respiratory problems, for which there is no cure. This might include learning how to administer medication for themselves; learning to monitor and understand their condition better and to plan and react appropriately when there is an issue.
There is some cross-over. For professionals and support agencies, this might look like:
What are the benefits of self-care/management?
The benefits of self-care are truly enormous and shouldn’t be ignored. Regular self-care can:
- Understanding of the impact of your behaviour of your health and wellbeing
- Prevent disease and illness
- Make you feel good
- Help you be more productive, engaged, and connected
- Make it easier to maintain your weight
- Improve your longevity and quality of life
The benefits of self-management include:
- A better understanding of any medical condition you have or the person you care for has
- How to spot changes that could become an issue before things get worse and know what to do about them
- Increased self-confidence to manage your health conditions and more control over your health in general which, in turn can reduce anxiety
- Understand how to manage medication and treatment plan
- What aids or equipment that might help – including new technology.
Why the focus on Sunderland?
Self-care isn’t a new thing here. We are conscious that a range of organisations across the city, including all the partners working with us as part of the vanguard, already have really effective initiatives and campaigns promoting self-care and self-management but our aim is to bring them all together around the table to discuss; share and develop a city-wide self-care programme that will ultimately benefit the whole population.
Who is it for?
Everyone can and should understand and employ self-care at some level throughout their lives.
We are not just looking at people who are already managing their own or a family member’s health but want to look at the whole community working with a range of organisations and groups – all to reinforce the benefits and an understanding of self-care, now and for the future.
To help health and social care staff; health champions and support groups identify those who could benefit most from some self-care/management support we are testing a tool called the ‘Patient Activation Measure’ (PAM). The PAM is designed to score people on the level of ‘activation’ (or likelihood) to manage their own care well and get the most benefits. You can find out more on the PAM pages.
Who is involved?
We have a core group of providers who have a direct involvement in self-care in the city, but plan to include and engage a wide range of providers from across the Sunderland area as the project develops. Currently partners making up the Sunderland ‘Self-care Implementation Group’ are:
- All Together Better
- Age UK Sunderland
- City Hospitals Sunderland
- Healthwatch Sunderland, Sunderland CCG, and General Practice representatives (in addition to members of the GP Alliance)
- Northumberland, Tyne and Wear Healthcare Trust – mental health
- Public Health Sunderland
- South Tyneside Foundation Trust – providers of community nursing
- Sunderland Care and Support
- Sunderland Carers’ Centre
- Sunderland Council – Adult Social Care
- Sunderland GP Alliance
Why is self care good for people?
Empowering people with the confidence and information to look after themselves when they can, and visit the GP when they need to, gives people greater control of their own health and encourages healthy behaviours that help prevent ill health in the long-term. In many cases people can take care of their minor ailments, reducing the number of GP consultations and enabling GPs to focus on caring for higher risk patients, such as those with comorbidities, the very young and elderly, managing long-term conditions and providing new services.
More cost-effective use of stretched NHS resources allows money to be spent where it’s most needed and improve health outcomes. Furthermore, increased personal responsibility around healthcare helps improve people’s health and wellbeing and better manage long-term conditions when they do develop. This will ultimately ensure the long-term sustainability of the NHS.
Around 80% of all care in the UK is self care. The majority of people feel comfortable managing everyday minor ailments like coughs and colds themselves; particularly when they feel confident in recognising the symptoms and have successfully treated using an over-the-counter (OTC) medicine before.
On average, people in the UK experience nearly four symptoms every fortnight, the three commonest being feeling tired/run down, headaches and joint pain and most of these are managed in the community without people seeking professional healthcare.
The Self Care Continuum
This diagram illustrates the sliding scale of self care in the UK, starting with the individual responsibility people take in making daily choices about their lifestyle, such as brushing their teeth, eating healthily or choosing to do exercise.
Moving along the scale, people can often take care of themselves when they have common symptoms such as sore throats, coughs etc, for example by using over-the-counter medicines. The same is true for long term conditions where people often self-manage without intervention from a health professional (DH figures state that people with long term conditions spend on average 4 hours a year with a health professional, which means the remaining 8756 hours are spent self-managing).
At the opposite end of the continuum is major trauma where responsibility for care is entirely in the hands of the healthcare professionals, until the start of recovery when self care can begin again. The NHS can support people to self care at any point during the continuum.
What happens when people give up on self-care?
Despite people’s willingness to initially self-treat, there are still 57 million GP consultations a year for minor ailments at a total cost to the NHS of £2 billion, which takes up, on average, an hour a day for every GP.
Research shows that people often abandon self care earlier than they need to, typically seeking the advice of a doctor within a period of 4-7 days. The main reasons for this are:
- Lack of confidence in understanding the normal progress of symptoms (e.g. a cold can last up to 14 days)
- The perceived severity and duration of symptoms
- Reassurance that nothing more serious is wrong
- A prescription to ‘cure’ the illness, even though the same medicine may be available over-the-counter
Often just simple changes aimed at meeting the needs of local communities can be very effective at encouraging increased self care. These include giving patients the information they need to care for their common ailments and to make healthy lifestyle choices, signposting people to the right local services and outreach work to provide health advice in non-traditional settings such as pubs, libraries and job centres.
In the GP consultation itself, involving patients in their care through shared decision making has also proved to be a successful approach. This has led the Royal College of General Practitioners (RCGP) to develop a free online learning module on ‘self care for minor ailments’ which is aimed at developing GP and nurse consultation skills to support self care for patients (please see “resources” button).
Self care has progressively gained widespread support from healthcare professionals and from key organisations in primary care. More than nine out of ten GPs also now believe that self care by patients has an important role to play in general practice.
Following the launch of the report ‘Self care: An ethical imperative’ in 2010, momentum for the campaign grew which led to the inception of the Self Care Forum in 2011. NHS England is a partner in the Forum, as are a number of eminent GPs and organisations including the Royal College of Nursing (RCN) and the National Association for Patient Participation (NAPP). The purpose of the Forum is to further the reach of self care and embed it into everyday life.