Self Care

Introduction

Self-care is widely acknowledged as an important solution to managing demand and keeping the NHS sustainable. Supporting people to self-manage common conditions such as coughs and colds could help bring down the 57 million GP consultations each year for minor ailments, a situation which costs the NHS approximately £2 billion and takes up to an hour a day on average for every GP.

Promoting the concept of self-care and increasing the awareness that there are alternatives to making GP appointments, or attendance at Out of Hours or A&E departments with minor conditions, will encourage patients to explore self-care in the future, so changing the culture of dependency on the NHS.

Derby and Derbyshire ICB spent over £9.5 Million in 2020/21 and the same again in 2021/22 on items that are available to purchase over-the-counter (OTC). It is recognised that some of this cost is attributable to long-term or complex conditions, but considerable spend is also for conditions that may be considered self-limiting and are thus suitable for self-care.

By reducing spend on treating conditions that are self-limiting, suitable for self-care, or on items with limited evidence of clinical effectiveness, these resources can be used for other higher priority areas that have a greater impact for patients. This includes supporting improvements in services and/or delivering transformation that will ensure the long-term sustainability of the NHS.

 

Medications should no longer be routinely prescribed for conditions that:

• may be considered to be self-limiting, in that they do not normally need treatment as they will heal or get better of their own accord, or
• are suitable for self-care, so that the person suffering does not normally need to seek medical advice and can manage the condition by purchasing OTC items directly (see table 1 for examples of medicines that fall into these categories).

In addition

• some products prescribed at NHS expense have insufficient evidence of clinical effectiveness and should no longer be routinely prescribed (see table 2)

 

Links for details:

• Self-care: Self Limiting Conditions (Table 1)
• Self-care: Medicines with Little Evidence of Benefit (Table 2)

Useful Resources

• Exceptions can be found in the full Self Care policy here

• Joined Up Care Derbyshire condition specific patient information leaflets can be found here

• Dental Factsheets for Healthcare Practitioners can be found here

Community Pharmacy and Pharmacy First

Community pharmacy should be the first port of call for patients seeking help for management of minor illness. The Community pharmacy consultation scheme (CPCS) connects patients with community pharmacy, providing convenient, same-day consultations with a community pharmacist.  Direct digital referrals can be managed by practice reception staff, saving GP time and appointments.

The new Pharmacy First service builds on the Community Pharmacist Consultation Service which enables patients to be referred into community pharmacy for a minor illness or an urgent repeat medicine supply. It adds to the existing consultation service and enables community pharmacies to complete episodes of care for 7 common conditions following defined clinical pathways (acute otitis media, impetigo, infected insect bites, shingles, sinusitis, sore throat, uncomplicated urinary tract infections).

See NHSE information page on Pharmacy First.