Patients’ self care – building up our resistance!

One of the big points of all Slash Trash and Privatise Partnerships/ Accountable Care Systems is the need for people to “self care.”

Is this really in patients’ best interests?

The UK Trade Association of the manufacturers of branded over-the-counter medicines, self care medical devices and food supplements, that can be sold at pharmacies, or retail outlets such as supermarkets and convenience stores, without a prescription, has jumped on the bandwagon.

The Proprietary Association of Great Britain’s “Self Care Nation” report  claims that,

“Making people aware of the impact of using GP and A&E services for coughs and colds is the key to NHS sustainability”

It recommends that people attend a pharmacy shop instead of consulting a GP over common treatable conditions like colds, sore throats and headaches:

However, an Advanced Nurse Practitioner said,

“This self care stuff is all well and good – there will always be those that come to the GP over trivia. But tackling demand is tricky and there’s a danger that some who need care are put off attending,  which is wrong. The concept of deeming ‘Headaches as a pharmacy issue’ is a worry. Headaches can be trivia and then again maybe not!  To my knowledge, pharmacists cannot do neuro obs nor diagnose headaches – would they be advising patients to see an optician/ seek review/exclude red flags? Similarly with back pain – are we talking simple long-standing, lower back pain stuff ? How will pharmacists safety net this?

I wonder if they are going to be explaining side effects, checking drug interactions against other medications and taking any responsibility for any issues caused by following their advice? Who will be accountable? Do pharmacists have the capacity to accommodate this role increase?

Controlling demand and handing back the problem off illness to patients seems to be the in thing – it makes you wonder why we even need GPs any more with all these self caring patients!

More cuts are coming to health visitors – big cuts. They are currently very low on staff and about to be cut further. They may be allowed to do only two visits a year to patients. At my Practice, mention was made of a scale of cuts where at-risk kids could be the only ones the health visitors would be seeing. Routine health visitor follow up would be much less frequent. In Bradford ladies in my practice no longer get the post natal check as routine and midwife follow up is also lacking. In terms of care in the community and supporting people to ‘self care’, these capacity factors are a worry”

Cuts to the Health Visitor Implementation Programme is damaging public health

Last year in a joint letter to the Times – signed by the CEOs of 11 health bodies, such as the Royal College of Nursing (RCN), Unite, the Royal College of GPs, the Royal College of Paediatrics and Child Health, the NSPCC and the National Children’s Bureau – professionals said cuts to the Health Visitor Implementation Programme is damaging public health.

The health visitor cuts are because responsibility for commissioning key public health 0-5 childhood services, including health visitors and family nurses, transferred from the NHS to Local Authorities in 2015.

As part of the NHS, funding for these services was ringfenced, but central government has slashed Local Authorities’ public health funding.

Janet Davies, Head of the Royal College of Nurses, said,

“Cutting health visiting roles would prove more expensive in the long term by putting added pressure on already overstretched GPs, hospitals and other health services.”

This shows how incoherent the government’s health policies are – they seem to be more about shifting public funding into corporate pockets than anything else. Rather than help keep people healthy with health visitors and other key community health and social care services, the government risks people’s health by cutting these key preventive services, then tells people when they fall ill to go to the chemist and pay for “self care remedies”.

Patient self care -forking out dosh for these companies’ products.

The Proprietary Association of Great Britain says its ambition is,

“to shape the consumer healthcare market… by acting as the voice of the industry, promoting self care for self-treatable conditions and providing a world-class service to our members.

Companies qualify for full membership of PAGB if they manufacture and/or market branded non-prescription medicines, self-care medical devices, food supplements or registered herbal medicines in the United Kingdom.

We also welcome applications for membership from companies that are seeking to reclassify a medicine, i.e. undertaking a switch from a prescription only medicine (POM) to a pharmacy (P) or general sales list (GSL) category medicine; or developing a new product.”

These are the PAGB members, on whose behalf PAGB is promoting patient self care – ie forking out dosh for these companies’ products.

We’re building up our resistance!

Obviously it is a good thing for us to feel confident in looking after our own health – and knowing the difference between when we can do that, and when we need to see a doctor or nurse practitioner. But when information about looking after our own health is tangled up with the claim that we need to stop wasting NHS time and money, that risks putting people off seeing a doctor, and as the Advanced Nurse Practitioner says, that is wrong. It also risks storing up illnesses and ailments until they are worse.We are working on building up our resistance!

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