What comes to mind when you think of the term self-care? For some, it might be a mindfulness app or a deep tissue massage – a way to relax, indulge and unwind, and evaporate the stresses of modern life. A quick online search returns everything from articles on beauty products, to celebrity interviews, and it’s no surprise that you may have heard the phrase used more regularly in recent years, with Google reporting interest in the term tripling in the last five years.
In my role as a GP, I’m regularly reminded that looking after the inner self is just as important than looking after the outer self, sometimes more so - particularly in an age where a reported one in four people are suffering with mental illness, and “burnout” being formally recognised by WHO. Whilst it is encouraging to see awareness of the concept of self-care visibly on the rise, I fear the misappropriation of the term to promote all things “feel-good” sometimes overlooks the fundamentals of self-care.
Self-care is defined as “the actions people take for themselves and their families to promote and maintain good health and wellbeing and to take care of their self-treatable conditions”. Though by definition this includes mental health as a parameter of good self-care, it’s not the only factor; it’s about taking care of your body, too. True self-care often begins by making very simple, but very necessary health choices, the choices some of us take for granted – knowing where to go when you’re unwell or what NHS service to use when you need help.
The extraordinary statistics that 57million people visit their GP and 3.7million people visit their local accident and emergency department as a result of minor ailment symptoms that could be treated by self-care, demonstrates just how important even basic self-care is. Examples range from self-treating a common cold with widely available over-the-counter (OTC) medicines, or by visiting a pharmacist to discuss a complaint. In fact, an estimated £810million is spent on GP’s appointments for self-treatable conditions every year – money that is sorely needed by the NHS when you factor in an ageing and growing population.
The term self-care was first used in 1972, when PAGB, the consumer healthcare association, which celebrates its 100th anniversary this month, sponsored the first NHS Panel on Self-Care, introducing the term to our national vocabulary. In March 2019, PAGB published a Self-Care White Paper, calling for a national strategy for self-care, including several policy recommendations which aim to help further embed a culture of self-care in the Nation’s behaviour and as part of the NHS, bringing self-care to the forefront once again.
These recommendations include allowing pharmacists to have access to read and write in patient records in order to join up care, and encouraging GPs to provide “recommendation prescriptions” to suggest treatments that can be bought over the counter at a local pharmacy rather than being prescribed. I know in my surgery I’m regularly scrawling information down for patients who do not necessarily require a prescription: from my perspective, formalising these recommendations for patients can only be a good thing.
Another policy recommendation proposed by PAGB is that of self-care being included as a mandatory part of school health education. This would allow children to cultivate a lifelong relationship with self-care for both mental and physical health – from knowing common illness symptoms and how to treat them, to where to go for health advice and treatment.
There are also ways we can incorporate very fundamental self-care into our lifestyles by making easy changes, such as knowing the correct medication for your illness (by visiting a community pharmacist for advice) or being able to identify the correct care pathway for yourself or those in your care (something of increasing important as GP appointments and A&E spaces become increasingly scarce). These actions not only empower us to take care of our own physical health, but also free up valuable resources and appointments in the NHS for others that may need them.
Public bodies such as The National Institute for Health and Care Excellence (NICE) are also placing an emphasis on self-care, with support for individuals and companies. As part of this move, they have recently issued guidance for employers, encouraging them to promote exercise and other healthy choices for their staff.
Effective self-care is a lifelong habit, and it means something different to everyone. Whatever self-care looks like to you, your family, or those you care for, it’s an important process that, when done correctly, will enable you to make appropriate mental and physical health choices, use services appropriately and for the benefit of all, and feel empowered to be self-sufficient in your own health care.
Dr Sarah Jarvis is a London-based GP. To find out more about PAGB’s campaign for a national strategy for self-care, click here.