Self Care, Who’s Failing?

I read this article with interest…and it made me think:


MPs criticise ‘lack of progress’ on NHS self care rollout



Its true, we are not doing enough to promote self care.

But who does self care belong to? I don’t blame Consultants, Senior Drs or Practitioners of any kind. They have knowledge and skills in their own specialist areas, thats what they talk about at consultation. Many are unfamiliar with self care concepts and how to approach those issues, particularly when there is limited time.

The Medical Model has served us well, in the past. The passage from symptoms to diagnosis, treatment and condition improvement has, for most, gone well. Thats great for those conditions which we can all experience if we are ‘dealt a poor hand’ or are unlucky.

But today there are so many more long term conditions, associated with lifestyle factors, which are bringing new pressures. The paternalistic approach of the NHS, which has managed to fix virtually everything we do to ourselves has to change. We no longer have the resources and its disempowering for us all. At what point did we agree to hand over responsibility for our health and wellbeing? Taking this back can help us and help the sustainability of the NHS We need to own our health and wellbeing, its a lifelong approach.

Reading through the literature, has made me ponder whether the success of the NHS, is part of our problem. The argument goes that those countries who pay health insurance are years ahead of us with Self Care. Acquiring conditions which are avoidable is a costly business, either for yourself or for your company, which provides health insurance. So individuals and businesses make a bigger commitment to minimising that cost. In this country we are short of any motivation that may bring.

I am not advocating ending NHS provision, before anyone gets the wrong message. However actions are driven by motivations and incentives. Presently ours aren’t well orientated to support the Self care agenda. Within workplaces, which are being encouraged to develop the wellbeing agenda (#wellbeing16, @CIPD), there is an implementation gap between those who say they wish to do it and those who actually do. Why? Well frankly many would wonder why they should. When there are health problems, the majority of the quantifiable costs are met by the NHS and there’s usually no health insurance costs to worry about.

For enlightened companies and organisations there are of course a good number of additional costs and benefits including employee engagement, improved productivity, talent retention, ease of recruitment and other reasons why they are actively pursuing the wellbeing agenda for the benefit of their organisation, their employees and their communities. Thats great and The Healthy Worker is delighted to have worked with many of them providing, amongst other things, courses which empower and enable employees to develop their own wellbeing and self care skills, achieving great results for themselves and their organisation.

So, where do we go from here?

For me, keep the NHS for its core work. Central to NHS is ‘H’, which is for ‘health’. By all means support the NHS to improve self care messages through training of Nurses, Drs and other Practitioners. But self care and wellbeing is wider than health, so also support workplaces with their desire to be part of improving wellbeing. There is now well established evidence of the business benefits from improving employee wellbeing. We need to incorporate that into management training and business performance measures. Employees are increasingly voting for this with their feet, and that people power is only going to increase. However it would be great to see Government policy lending its hand and creating the incentives for the change they wish to see.