The Self Care NHS Trust. The future for NHS Choices?

The new year started with a clear warning about the impact on the NHS of rising numbers of people living with long-term conditions: the costs of delivering current models of care are increasingly recognised as being unsustainable and acceptance of the need for change is growing. To my mind, however, viewing the problems of current models of care as simply about affordability misses a more important point.

The new year started with a clear warning about the impact on the NHS of rising numbers of people living with long-term conditions: the costs of delivering current models of care are increasingly recognised as being unsustainable and acceptance of the need for change is growing. To my mind, however, viewing the problems of current models of care as simply about affordability misses a more important point.

While the NHS may have been one of Britain’s greatest civil achievements of the 20th century, without some significant change it could become an albatross round the neck of 21st century healthcare. Contrast the NHS with health systems developing in emerging economies, and you might conclude that the NHS too often infantilises people as ‘patients’ and fails to harness one of the most significant assets at its disposal: our ability to self manage and self care.

There are some great innovations to support self care, like the award-winning Sleepio app which applies cognitive behaviour therapy to support people overcome insomnia, or SAM, an app that offers a range of self-help methods for people who are serious about learning to manage their anxiety. With an increasingly internet-savvy population using a multitude of apps to help with various aspects of daily living, it feels like time for healthcare professionals to start seeing these possibilities as integral to the healthcare offer.

There are also some great examples of innovations happening locally. Many of the integrated care pioneer sites will be looking at how self care and self management can become integral to the current healthcare offer. But the real gains will be made by combining localised support – such as walking groups, cooking clubs, group consultations – with the sort of virtual support that can be provided remotely and at scale.

I think that, as a national health service, it would be a wasted opportunity not to consider how these virtual services could be accessible to everyone, regardless of where they live. The NHS Choices website is currently the only NHS service that isn’t subject to the postcode lottery. While it goes a long way to providing relevant and reliable information to help inform people about their conditions and the services and support available, too often it stops there. It falls short of helping people to take a more active role in their own care.

NHS Choices needs to go beyond information giving and start connecting people locally (as Mumsnet has already achieved, for example) as well as virtually, along the lines of successful websites such as PatientsLikeMe. It could also host online training programmes (like Activate Your Heart, by University Hospitals of Leicester NHS Trust) as well as provide endorsed apps to support people in their self care.

However, making a real shift in the prevalence of self care and self management requires healthcare professionals to encourage and support these behaviours. Virtual care needs to be incorporated into an NHS that is too often defined by bricks and mortar. With more interactive resources available online through NHS Choices, healthcare professionals could guide people to the relevant parts of the website to access useful resources and information.

Essentially, NHS Choices could become the Self Care NHS Trust, universally accessible to healthcare professionals and the public alike to complement and – where appropriate – replace our pre-internet service models. What do you think?

Jo is Director of Strategy at the Health Foundation, www.twitter.com/JoBibbyTHF

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