The role of self care in a

sustainable healthcare

system

Deon Schoombie

Australian Self Medication Industry

Overview

• Defining self care

• Sustainability of healthcare system – challenges

• UK experience with self care

• Consumer perspectives on self care

• Impact of non-prescription medicines

• An Australian Self Care Alliance

Self care - common themes

• Individuals, children, families, friends, communities &

carers

• Promote health, prevent illness & accidents, cope with

illness & disability

• With and without support of healthcare professionals

• Encompassing all aspects of daily living - hygiene,

nutrition, lifestyle, environmental & socio-economic

factors & cultural beliefs

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Defining self care

Definitions:

• WHO: 1983,1998 & 2013

Self care is the ability of individuals, families and communities to

promote health, prevent disease and maintain health and to

cope with illness and disability with our without the support of a

healthcare provider.

• UK Dept. of Health paper: Self Care – Real Choice

(2005)

• Health policy perspective (Segall & Goldstein 1989):

Self care is the basic level of healthcare in all societies.

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Self care – what it isn’t

• Self care doesn’t mean no care

• It doesn’t mean diverting people away from

healthcare services

• It doesn’t mean individuals are left to look after

themselves

• Self care is not what individuals do instead of

going to the doctor, it’s what they do between

visits.

Person-centred care – key themes

• Respect for values, needs & preferences but

also capacity, capabilities & skills

• Partnership & responsibility – collaborating &

sharing

• It requires a supportive environment

Challenges

Australian Health Policy Institute report (2001):

• There is far more that we can do than we can afford to

do.

• There is a problem with rising community expectations

• The ageing population

• Increasing willingness to pay for expansion of medical

care through government spending alone

• All of us need to be better informed about health so our

choices can be more intelligent & demands for

healthcare becomes more restrained than they are.

UK Self Care Policy

• 2000 - Self care on national health agenda

• 2000 – Pharmacists positioned on frontline of

self care strategy

• 2000 – Wanless report:

– Fully engaged patient in all aspects of healthcare

– The patient as partner & resource

– Self care a prime example of effective partnership

– Evolutionary strengthening of patient responsibilities

Consumer perspectives

Eppossi Barometer (2013):

• Understand the concept

• Understand the benefits

• See it as vital part of managing health & disease

• Acknowledge responsibility and willing to take on more

• Minority feels confident to do so

• Health literacy is pivotal

• Don’t view self care as partnership with healthcare

professional

Recommendations

• New policies needed to define the role of healthcare

professionals in self care

• Greater emphasis on shared care

• Government must make self care integral to health policy

• Government should seek improved partnerships with

stakeholders to improve outcomes by sharing data &

resources

• Key role of health insurers & healthcare providers need

to integrate incentives for self care

Impact of self medication

• Current & potential value of non-Rx meds:

– GP visits: $5bn

– Productivity - $7.5bn

• Every $ spent by consumers on 8 OTC

medicines saves $4

The case for self care in Australia

• Translating greater personal responsibility into

practice

• Recognise consumers as a healthcare resource,

not just users

• Making better use of professional healthcare

resources

A new population health strategy

Zollner & Lessof:

• Securing a champion

• Constructing partnerships

• Engaging with private health sector

• Meaningful consultation

• Promoting accountability – monitoring progress &

empowering citizens

An Australian Self Care Alliance

Thank you

deon@asmi.com.au