Former chair of the Royal College of General Practitioners Professor Maureen Baker explores how self-care can impact patients’ health and relieve pressures on the NHS
This is an edited version of an article that originally appeared on Digital Health
In recent months confusion and debate have taken centre stage over whether GPs should focus their consultations via face-to-face appointments or adopt total triage. Last November Matt Hancock told MPs that delivering 45% of GP consultations remotely felt ‘about right’. Earlier this year NHS England stated that NHS organisations should ‘continue to support practices to significantly increase the use of online consultations, as part of embedding total triage’. They further suggested that embedding total triage into the health service could be an ‘enduring legacy of the pandemic’.
However, on May 13, NHS England issued new guidance to practices stating that general practice patients must now be offered face-to-face appointments if that is their preferred mode of consultation. NHS England said practices should ‘respect preferences’ for face-to-face care, unless there are reasonable clinical indications for the contrary, such as the presence of COVID-19 symptoms. This guidance has faced fierce backlash from GPs, as they publicly condemned the ‘blanket’ demand from NHS England, with many calling the guidance ‘tone deaf’ and ‘badly judged’.
Digital vs face-to-face
With continued debate around the merits of face-to-face GP consultations in comparison to handling initial appointments via a digital solution, one must question whether these are the only two options for managing a patient’s health and reducing strain on GPs.
One avenue of exploration that is often overlooked is the importance of patient self-care and what I like to call ‘pre-primary care’ – the management of your health before you even contact your GP.
With the COVID-19 pandemic accelerating the adoption of digital health and technology, we’re now seeing patients feel much more empowered to adopt a more proactive responsibility in managing their own health. In a survey commissioned by self-care platform Healthily of 2,200 adults and 100 GPs from across the UK, over half (55%) of the 2,200 adults said that they had been managing their health and wellbeing through self-care at home since the start of the pandemic, and 46% said they have been managing their wellbeing/health by taking better care of their health. In addition, nearly half (47%) of adults said they proactively manage their wellbeing by taking lots of steps to ensure they are healthy.
Building healthy habits
At Healthily, where I am chief medical officer, we consider self-care to be any action we take independently to support our physical and mental health. It’s about building healthy habits, noticing if something’s not right, knowing how to take care of yourself when that’s the best thing to do, and knowing when to see a health professional. While self-care can dramatically impact the health of an individual, this practice can also help to relieve pressure on the NHS and GPs themselves. In the referenced survey, GPs said half of all appointments are for conditions that could have been managed by patients themselves.
Perhaps instead of solely focusing on ‘digital healthcare’ as different modes of accessing your GP, we could instead look at the incremental gains made by re-routing the patient pathway away from GPs when care needs can appropriately be met elsewhere. During the first lockdown more than one-in-ten of those surveyed (12%) turned to healthcare apps or websites for advice and support instead of their GPs; of these, four-in-ten (41%) reported doing so to relieve pressure on the NHS.
This new group of digitally enabled self-carers are the bright spot of behaviour change we could pour more oxygen on to help burn a brighter path around primary care. Patients can play a significant role in managing their health using digital apps and websites that provide safe, reliable advice so that people can make the best health decision for them.
This will, potentially, free up critical services for those who need to seek clinical support for critical timely diagnoses and referrals.