Chapter VI. EU policy recommendations on self-care
This chapter aims to pull together the principal conclusions from the above four sections : 1. review of existing EU policy, 2. needs of persons/patients, 3. socio-medical environment around the persons’/patients’ needs, 4. impact of self-care systems on the EU health systems and the relevant policy implications of the work within WP1 (guideline on how to promote self-care within the EU) and WP2 (guideline to help member States and stakeholders to develop and produce communication tools on self-care). In addition it aims to include the gender dimension, socioeconomic circumstances related to access to healthcare and health inequalities, including in relation to (un)documented migrants and disability.
The EU policy recommendations that result from the 4 main sections, above are:
- General recommendations on self-care for minor physical health conditions
- Linkages with existing EU policies would need to be fine-tuned to ensure coherence, increase predictability and limit unintended effects that each separate policy may have on the other.
EU policy on self-care should be well integrated with existing policies, have a clear long-term strategy and be communicated across policy sectors (from health to social, regional development (cohesion policy), education, research, employment and economic policies).
Self-care policy should be formulated and implemented together with and not against other policies. Promotion of self-care in all policies should take into account the social gradient and not exacerbate health inequalities. The special needs of citizens who are institutionally hard to reach should be specifically addressed in any such initiative. The impact on existing pieces of legislation or potential links should be considered.
- Self-care should also be defined from a policy perspective to clarify the role of related policies that contribute to it: health literacy, patient empowerment, access to healthcare, self-medication, self-management, patient safety and long-term care. There is an urgent need to tackle all pre-conditions to achieve self-care successfully as tackling for example only health literacy and not patient empowerment, would be insufficient.
- Specifically, time and time again the need for greater health literacy as a cornerstone of successfully implemented self-care policies is pointed up. Although there have been some valuable recent research studies addressing this topic, the need for a coherent Europe-wide initiative to increase levels of health literacy is evident.
- Useful concepts explained in Chapter II, such as ‘productive interactions’ and participative learning may be transferred from existing models such as the chronic into a future self-care model for minor ailments.
- National guidelines for the 5 minor ailments developed within WP1 should be promoted at EU level and included within the future self-care policy as effective implementation tools.
- The website developed within WP2 could be used as a digital self-care platform at EU level.
- EU policy on self-care should encourage (/allocate funding for) small pilot projects taking into account social and cultural variations and social structures in both urban and rural areas to pre-test and validate necessary interventions to promote self-care. Self-care should not lead to disempowering of care communities and should not be an excuse for insufficient access to healthcare in rural areas.
- There is a need to create a repository of best practices on training of healthcare professionals as well as self-care interventions. There are clear recommendations from previous policy briefs that education of health professionals in communication and specific skills related to promoting self-care need to become part of the professional curriculum but also be routinely assessed as part of the quality criteria by which the performance of professionals and the health system is assessed.
9.Employment practices may include the provision of well-being programmes, thus contributing to reduced loss of income through sickness and improved citizen awareness of the need for self-care. The added-value of such schemes needs to be evaluated and should be integrated into consideration of future policy on self-care. On the other hand, the requirement to always present a medical certificate when on sick leave, where this exists (self-certification for short periods exists in some MS) represents a barrier going against self-care principles and discouraging self-care. These matters are worthy of investigation as they represent influences external to the healthcare system that impact on this issue.
- The cost benefit analysis carried out as a precursor to this study demonstrates the major problem that there is insufficient data currently available to allow more sophisticated analysis of the true impact of self-care on health systems from an economic point of view.
That report makes various recommendations as to further research which needs to be done to remedy this.
Specific recommendations on the 5 minor conditions:
- Athlete’s foot
- Heartburn (without indigestion)
- Lower urinary tract infection
The specific recommendations on the 5 selected minor conditions will follow.
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