Health and Care Bill

Lord Clement-Jones Excerpts

Lords Hansard _ Part 1 & Report stage
Wednesday 16th March 2022 Lords Chamber

[Lord Hunt of Kings Heath (Lab)]

My Lords, Amendment 165 requires the Secretary of State to

“promote self care for minor ailments and prepare a national self care strategy”.

I hope that Ministers will just agree to this, without very much debate.

Self-care is defined as

“the actions individuals take for themselves, on behalf of and with others, to develop, protect, maintain and improve their health.”

It is an important but often overlooked part of the primary care pathway.

Given all the pressures that there are on the health service and that there are going to be over the next 30 to 40 years, surely we should do everything we can to encourage self-help for minor ailments. During Covid, the importance of self-care in reducing the burden on GPs and A&E became very self-evident. Since the outbreak started, people with minor ailments were not able to visit their GP in the traditional manner and learned, or at least practised, self-help behaviours instead. A survey carried out by PAGB, the consumer healthcare association, during the first national lockdown indicated that the pandemic has had an impact on people’s attitudes to self-care. Some 69% of people who would not have considered practising self-care prior to the pandemic said that they were more likely to do so after their experience of lockdown.

Interestingly, if the Government were prepared to run with this strategy, there are all sorts of behaviours that they could start to encourage. They could ensure that individuals understand or are willing to practise self-care; ensure a cultural shift among healthcare professionals toward well-being, enabling people to self-care; ensure that the system is supported to encourage self-care where appropriate, with pharmacies, of course, playing a big role in that; encourage the use of digital technology; enhance the national curriculum on self-care for schoolchildren; and introduce self-care modules in healthcare professionals’ training curriculum.

I come back to the point that the Minister and noble Lords know that the health service is currently under huge pressure, not just because of the backlog. Already before the pandemic, the health service was really struggling to meet its targets. The demographics, the growing older population and all these factors suggest that the NHS will struggle hugely to cope with the pressure on it over the next 20, 30 and 40 years. Surely some part of the strategy to deal with this is to encourage all of us not just to look after our own health more but, where we can, to self-help. I would have thought that message would have been accepted with alacrity on the Government Front Bench. I hope the Minister will be able to say that this is very much taken to heart and that the Government really will start to drive the new strategy. I beg to move.

[Lord Clement-Jones (LD)]

My Lords, I rise briefly to support Amendment 165, in the name of the noble Lord, Lord Hunt, and thank him for putting it forward. Self-care has an important role to play in supporting people to manage their own health needs, and also in alleviating an unsustainable demand on GP and A&E services. As the noble Lord described, prior to the coronavirus pandemic there were some 18 million GP appointments and 3.7 million visits to A&E every year for conditions which people could have looked after themselves or sought advice from a pharmacist. It is estimated that this was costing the NHS in the region of £1.5 billion a year.

During the coronavirus, again as the noble Lord described, surveys have shown a much greater willingness among members of the public to self-care for these self-treatable conditions. But it is vital that appropriate policies are put in place to ensure that, as we emerge from the pandemic, people who can self-care continue to do so. It is evident now that self-care can help address many of the challenges we face in the NHS today, but to do so we need to address some of the system barriers to self-care, as described in this amendment, and unlock the important behavioural shifts that enabled people to self-care during the pandemic.

In particular, I will highlight how the NHS can make much better use of digital technologies and community pharmacists to enable people to self-care. We need to make better use of the technologies that the NHS has embraced over the course of the pandemic, such as the Covid-19 symptom checker on the NHS website. The digital triaging technology should be used to support the expansion of the community pharmacist consultation service to enable people to follow an algorithm online to get a referral for a consultation with a local pharmacist. It is critical, if we are to optimise the role of pharmacists—I am a big supporter of community pharmacists—that we give them the digital tools and information they need to support people. At present, a pharmacist cannot routinely record the advice or medication they give people, despite receiving training. The NHS must address the question of interoperability in IT systems, so that pharmacists can have access to read and to input into people’s medical records and enable pharmacists to be a core part of an individual’s primary healthcare team.

6.15 pm

The pandemic has highlighted how quickly the NHS and patients can adopt technological and digital changes. Realising the Potential: Developing a Blueprint for a Self Care Strategy for England, a document launched last October, is an excellent blueprint for this. A whole range of organisations, including NHS clinical commissioners, the RCN, pharmacy organisations, the Self Care Forum and, of course, the PAGB, have worked together to develop this blueprint for a comprehensive national self-care strategy to support the introduction of self-care policies throughout the NHS in England. It contains policy proposals and case studies, in particular in relation to digital technologies, which set out how the NHS can fully embed self-care and pharmacy into primary care.

I hope the Minister today will outline how the Government are ensuring that the NHS can adopt these proposals, which learn from the pandemic, and will expand them to support individuals to enable self-care.

[Baroness Wheeler (Lab)]

My Lords, we had a good debate in Committee on the issue of self-care and the management of health conditions, particularly on its importance as a key part of the primary care pathway. This was underlined in diabetes care and, as I also emphasised, in the care and treatment of people with rare diseases, most of whom are living with lifelong conditions. As vice-chair of the Specialised Healthcare Alliance of charities supporting this key group of patients, I know that they often do not feel sufficiently supported in terms of care and support and health and system information, and with physical and daily living.

As the two noble Lords have stressed, the Health Foundation’s research on the effective self-management by patients has shown a significant reduction in the need for emergency admissions to hospital and in A&E attendances, and fewer GP appointments. In this context, Amendment 165 makes a great deal of sense. If patients with, for example, rare diseases receive appropriate support to manage their less intensive care needs, then promoting self-care has the potential to help them prevent their conditions from deteriorating, to improve their lives and to reduce demands on the NHS, as the noble Lords have stressed.

We therefore strongly support the need for the development of a national self-care strategy, starting with awareness raising among primary and secondary children on how to self-care, and with appropriate staff and management training of healthcare professionals. Improved technologies, as underlined by the noble Lord, Lord Clement-Jones, especially those developed during the pandemic, will have a key role in broadening access to effective self-care and ensuring the better support from primary and community pharmacists that we all want to see. I hope the Minister will respond positively to this amendment.