Memorandum by PAGB (SAV 02)
SAVING MONEY IN/GETTING BETTER VALUE FOR
MONEY FROM THE NHS
ABOUT PAGB
PAGB (Proprietary Association of Great Britain)
is the national trade body which represents the manufacturers
of non prescription medicines and food supplements. PAGB was founded
in 1919 to regulate the advertising of member companies' products
through pre-publication scrutiny. This process led to the development
of the PAGB Code of Standards of Advertising Practice. This system
of self regulation continues of all products in membership. From
1987, PAGB has commissioned baseline surveys into self care and
self medication of minor ailments.
1. Summary
— Patients seeking the advice of a healthcare
professional for minor ailments is a grossly inefficient use of
NHS resources.
— This issue alone results in £2 billion
a year of unnecessary NHS spending.
— However, research conducted over 22 years
demonstrate that people have not changed their behaviour in either
the extent to which they self care for their minor ailments nor
in the quantities of visits to GPs for such ailments, which now
take up almost a fifth of GP workload.
— This behaviour is based on:
— Continued dependence on the GP.
— People electing to use the NHS to satisfy
a demand for care, rather than clinical need—these two positions
are significantly different.
— The founding principle of the NHS is
that care is provided free at the point of use, and based on clinical
need not the ability to pay. But during its 62 year history, the
common understanding of "clinical need" has moved towards
"demand for care"—this must be redressed.
— A demand-led culture cannot be sustained
by a service with finite resources—the NHS is already in
deficit, and will be facing greater demands in the future to care
for a population now living longer with long term conditions and
co-morbidities.
— Changes in patient behaviour and culture
are needed now, both in schools and medical training to address
the issue.
— Furthermore, minor ailments are generally
dealt with most effectively by people opting to self care; consequently
the practice of self care is a "win-win" for both the
general population and the NHS.
2. What are minor ailments?
Minor ailments are part of every day life for
us all—the most common are:
— Headaches and migraine.
In most cases people manage these minor ailments
through self care using an Over the Counter (OTC) product, but
PAGB's research indicates there is often a significant level of
dependency on the doctor.
The research shows that people often abandon
self care in favour of a trip to the doctor. Typically, this switch
is made within a period of four to seven days. According to GPs,
this is earlier than needed, generating unnecessary consultations.
3. The scale of the problem
The first major study into NHS resources used
for treating minor ailments was commissioned by PAGB, and undertaken
by IMS in 2007. The study was tasked with quantifying GP workload
for minor ailments and the associated costs.
Research showed high volumes of GP consultations
for minor ailments:
— 57 million consultations per year (51.4
million of which involve a minor ailment as the sole reason for
seeking the consultation).
— Almost a fifth of GPs' workloads were
for minor ailments alone.
— Overall, minor ailments account for £2
billion of NHS funding a year, £371 million of which are
for the prescriptions written in 91% of the consultations.
4. Rationale for Self Care
A culture of dependency has built up, whereby
patients lack the confidence to manage minor ailments themselves
through self care for the appropriate amount of time before seeking
medical advice.
This must be addressed if we are to maximise
the efficiency of NHS spent in these times of tightening budgets.
The three main reasons why this culture of dependency
must be met are:
— To help alleviate current demands on
the NHS for minor ailments, in particular, the GP.
— To help people to strengthen their ability
to self care thereby empowering them to be more confident and
independent in their attitudes and behaviour.
— To make time and cost savings in the
NHS amounting to £2 billion.
5. How can greater self care be delivered?
Increasing the level of self care will require
addressing the culture of dependency, and giving patients the
support they need to feel confident in treating their own minor
ailments.
There are four clear steps to be taken to ensure
self care is increased:
1. Recognise it is time to change the culture
of dependency for minor ailment.
2. Develop a training package for healthcare
professionals (GPs, pharmacists and nurses) on how to conduct
self care aware consultations.
3. Initiate a social marketing campaign to educate
people to understand and manage self limiting conditions so that
GPs' and practice nurses' time is freed up to look after more
complex conditions.
4. Introduce a comprehensive health education
package in schools to ensure future generations use the health
service efficiently through the PSHE curriculum.
10 March 2010
| 
