Educating and informing patients how to manage their own conditions has the potential to significantly reduce appointments
As a large training practice, St Lawrence Surgery places a huge emphasis on education for staff and patients, and implementing a self-care strategy which empowers patients to make informed decisions about when and how they access healthcare seemed like a natural progression.
Everyone is highly committed to helping our patients to look after their own health better, and a key part of this is providing information and advice. This lets patients know what they can do to look after their own and their family’s health without the need for medical intervention, such as how to self-manage the symptoms of minor ailments at home. Of course, with the NHS under considerable pressure, this has the added advantage of reducing patient demand and ensuring valuable appointments with the right healthcare professional are available when patients really do need them.
With 57 million consultations a year involving a minor ailment at a cost to the NHS of £2 billion in GP time and prescription costs, I truly believe that having an effective self-care strategy in place is essential for all practices. Promoting self-care doesn’t require extra funding, but having patients who are empowered and knowledgeable about their own health enables precious NHS resources to be used much more cost-effectively.
Developing a self-care strategy
Along with Chris Moon-Willems who is the self-care champion for St Lawrence’s Patient Participation Group (PPG), I attended the 2012 Annual Self Care Conference. Hearing about some of the fantastic initiatives taking place around the country inspired us to put some of those ideas into practice at our own surgery, as well as think about what else we could do.
Working initially with our PPG, feedback found that patients were keen to learn more about what they could do for themselves to stay healthy and manage their health better. Our enthusiastic PPG was very involved in helping to develop self-care activities and wanted these to have a community feel.
As well as getting our PPG on board, I held practice meetings to discuss and agree the self-care strategy with all members of staff. It is important to involve everyone that interacts with patients at the surgery, including receptionists, nurses, GPs and the pharmacist to ensure everyone is committed, understands what their role is and gives consistent advice. It is no good, for example, having a policy on no antibiotics for viral sore throats when some nurses and GPs adhere to the policy and others don’t! Patients will ‘nurse or doctor shop’ until they get the antibiotics they believe they need, which leads to more appointments being taken up inappropriately.
What does St Lawrence Surgery do to promote self-care?
Getting messages about self-care across to people and engaging them in their own healthcare is at the heart of our self-care strategy and to reach different groups of patients a number of different communication methods are used.
The PPG takes a lead role in organising community events and these have gone from strength to strength. People come along to the health promotion days because there is a fun and social element with tea, cake and entertainment. However, they provide an opportunity for people to have health checks and ask our ‘street doctors’ and ‘street nurses’ questions about their health in a friendly and approachable environment. While our surgery cares for a large elderly population, we also encourage families to attend by having a children’s entertainer, for example.
Other PPG activities have a focus on people’s wellbeing which can then have a positive impact on illnesses such as depression. The PPG has arranged everything from coffee mornings to choir practice to Pilates classes! A walking club, the St Lawrence Strollers, meets weekly.
We also host patient education events on particular health topics that are often suggested by patients. Forthcoming topics currently include how to prevent diabetes, how to prevent and manage high blood pressure and managing back pain. Not only do these events help people manage their own long-term conditions and prevent ill health, but they equip people with the kind of knowledge that can dramatically reduce the level of medical intervention they require.
Another useful resource for those who are able to access the internet is the surgery’s website. This includes lots of health information, such as how to self-treat minor ailments at home. Fact sheets on the most common minor ailments that have been developed by the Self Care Forum can be downloaded from the site. These explain what symptoms the patient can expect, how long they should last, what the patient can do to relieve them, as well as highlighting the more serious symptoms that indicate the patient should seek professional medical advice. Research has found that one of the main reasons that people give up on self-care and seek the advice of a doctor too early is because they don’t realise just how long the symptoms of ailments like coughs and colds can go on for.
Practice staff have also made themselves aware of the normal duration of symptoms for when patients call the surgery and printed versions of the fact sheets are also held in a display rack where patients are encouraged to take copies home to ‘take control and manage your symptoms’.
Staying in touch with patients proactively before they even think to contact the surgery is another way of saving huge amounts of time and money. We’ve set up email groups and send out our newsletter with details of upcoming events, as well as emailing health tips to people with particular long-term conditions, such as information regarding winter weather problems. We also use text messages to remind people about appointments but hope to expand this to send health advice too.
Every practice can do it
As a self-care surgery, I want to share our ideas with other practices so they and their patients can also benefit. While we are continually looking for new and innovative ways to empower and educate our patients, many of the things
that practices can do, such as consistent information about minor ailments, are really very simple and don’t incur any extra cost.
For help getting started, a wealth of resources including the fact sheets mentioned above and a guide for practices on implementing a self care aware approach to demand management can be found on the Self Care Forum website at www.selfcareforum.org .