Policy Proposals
The nine policy proposals presented in the Blueprint are a suite of separate initiatives that will address one or more of the barriers and gaps that currently inhibit the potential for self-care.
Each proposal will make a difference but together the proposals will improve population health through the prevention and better management of disease and decrease health inequities by reducing the impact of the social determinants of health.
National health literacy strategy
Develop a national health literacy strategy aimed at improving health literacy and self-care capability for all
Investment in strategies that build individual and population health literacy capacity is critical for disease prevention and management and improved population health, as well as for health protection during public health emergencies such as the COVID-19 pandemic.
A national health literacy strategy would contribute to the prevention and more effective management of infectious and chronic diseases, and improved health status for all.
The national health strategy should:
Identify and target
the health literacy needs of disadvantaged and at-risk individuals, communities and population groups through all primary health care services and health promotion initiatives.
Build system capacity
through the National Safety and Quality Health Service Standards and accreditation processes and by:
- establishing health literacy competencies and embedding them into professional education and continuing professional development and workforce accreditation standards;
- implementing organisational self-assessment of health literacy practices, capabilities and responsiveness for health service providers, including their understanding of health literacy needs within their catchment populations;
- developing concise, valid and reliable measures for health literacy to be used in periodic population surveys and as a practical screening instrument for tailored interventions; and
- investing in medical and health research to identify and address health literacy needs in disadvantaged communities and at-risk population groups, particularly culturally and linguistically diverse communities, using place-based approaches that engage communities in their implementation.
Self-care core competencies
Invest in the development of cross-disciplinary self-care core competencies for all relevant health professionals and other care workers, engaging with consumer representative organisations, healthcare providers, health workforce peak bodies and professional colleges in a collaborative process
Establishing core competencies and defining roles for optimised self-care support by relevant health disciplines.
This will enhance the capabilities of healthcare workers (HCWs) and enable greater workforce flexibility for service providers to support self-care by all health consumers.
Health workforce
Health workforce self-care competencies should include:
- understanding their role and responsibilities in supporting self-care for disease prevention, treatment of minor ailments and self-management of chronic conditions;
- understanding and demonstrating skills in collaborative, multidisciplinary and ongoing team-based care with an explicit focus on shared decision-making;
- relevant health literacy competencies and skills;
- communication skills that engage and motivate consumers; and
- skills to assess and identify individual self-care capability across a diverse range of healthcare consumers and to tailor interventions accordingly.
Professional bodies
Peak bodies, professional colleges and accreditation authorities should embed self-care core competencies in professional training, education, and workforce accreditation where applicable.
National health & consumer engagement framework
Invest in the development and implementation of a comprehensive national health and consumer engagement framework
Involvement of consumers in decision-making about their health care needs, in partnership with health professionals, is recognised as contributing to better health outcomes.
The ability to choose and have some control over treatment options can also increase the capacity of individuals to engage in informed self-care, such as self-management of established health conditions.
Consumer engagement framework
The national model consumer engagement framework should aim to provide and enable systematic monitoring of:
- practices and processes for sharing decisions and planning care between consumers and treating health professionals, including communication and training for healthcare professionals; and
- the engagement of consumers as partners in the design and monitoring of policies, service planning and delivery and evaluation.
Framework uptake and use
Uptake and use of the framework and performance indicators by all relevant health services and care providers should become a condition of health funding arrangements.
Digital health information and resource library
Establish a national digital health information and resource library and national quality assurance framework to assess the quality and credibility of web-based health resources and mobile health apps
The proliferation of technology and access to online information has dramatically increased the spread of misinformation about health and health care.
The development of a quality assurance framework to assess the credibility and quality of mobile health apps and web-based resources would enable health professionals and other care workers and consumers to access trusted and appropriate health information.
Build on existing work
The national library should build on existing work towards a national approach for health mobile apps and promote voluntary participation by digital information providers.
Online apps
The national library would provide evidence-based online health resources and mobile health apps for consumers, health professionals and other care workers.
Self-care support assessment tools
Develop and implement validated self-care and self-care support assessment tools, evaluation measures and reporting mechanisms
Self-care for the prevention and management of disease and minor ailments is a relatively new concept in policy, system planning and system performance. Measurement and evaluation is essential to demonstrate the effectiveness of any policy, program or intervention.
Without validated, generic measures and tools to comprehensively assess self-care by individuals, or to evaluate the provision of self-care support for consumers by healthcare providers, self-care activity cannot be identified as an outcome measure of health care within the health system.
Tools and measures should include:
Individual self-care status
A validated, universal measure of individual self-care status incorporating existing metrics related to self-care capabilities, patient activation and exposure to common lifestyle risk factors.
Service assessment tool
A comprehensive tool for assessing health services’ self-care support for consumers
Evaluation & reporting
Appropriate evaluation and reporting mechanisms to monitor self-care activity over time.
Funding and service models
Implement funding and service models that enable and support self-care
Health care financing and health service design are significant drivers of the quality, accessibility, and coordination of care, all of which are important precursors for the provision of best practice self-care support. Implementation of blended funding models (incorporating multiple funding mechanisms into a single system) would remove many perverse incentives that exist within fee-for-service payment systems.
This would also enable multidisciplinary, integrated, coordinated and collaborative models of care, and facilitate the provision of self-care support by health services and increase self-care activity by individuals.
Funding and service models should include:
Blended funding arrangements
Blended funding arrangements that enable and facilitate multidisciplinary primary health care services to deliver comprehensive collaborative care, preventive health, and social care interventions, including explicit support for consumer self-care engagement.
Research and clinical practice trials
Support for research and clinical practice trials to inform the development of innovative service models and funding arrangements to enable self-care support and preventive care as routine and systematic components of primary health care delivery.
Innovation and development fund
Establish a long-term preventative health and self-care innovation and development fund
The role and capacity of individuals in maintaining their health and in preventing and managing disease through self-care knowledge and engagement has had insufficient recognition.
A national investment fund dedicated to the development of preventive health care practice and resources, emphasising self-care information, education, training and support and governed by an independent expert body, would lead and drive the reorientation of health care towards prevention.
Fund establishment
The fund should be established with a mandate to facilitate and expand preventive health and self-care engagement, to invest in and support the expertise of health professionals and health services, to address disadvantage, and to lift self-care capabilities in individuals and communities. The fund would aim to reduce costs in the treatment and management of preventable health conditions through evidence-based and clinically reviewed information and training, treatment and referral resources.
Fund Governance
The fund should be governed by an independent expert board comprising public health and chronic disease experts, primary care clinicians and consumer representatives appointed by government. The fund should complement and support the forthcoming National Preventive Health Strategy and could be incorporated within the Health Innovation Fund.
National Self-Care Service (NSCS)
Establish a National Self-Care Service (NSCS) to provide national leadership and influence system change to embed self-care in health practice and services and to engage, inform and resource individuals, families, and communities in practising self-care for better health
Enabling health services and the health workforce to provide appropriate services to engage the Australian population in informed self-care.
This could be achieved systematically through establishment of a dedicated national education, information and quality standards body to resource the health services system and provide public information, education and support.
The NSCS should be governed by an independent board of consumer and health professional experts and should include:
Information for health services
Develop and promote evidence-based self-care information, education, guidelines and resources for health services, health professionals and paraprofessionals.
Information for individuals & groups
Develop and promote information and resources for individuals, families and communities, including a digital information and education platform.
Measurement & reporting
Measure and report on the uptake of resources, guidelines and online information to inform ongoing quality improvement and outcomes of improved self-care practices and consumer engagement on population health.
"Health in all policies" governmental approach
All levels of Australian governments should establish ‘health in all policies’ approaches that emphasise the prevention of disease and support individual and community capacity for engagement in self-care to improve population health
Health and the capacity to self-care are influenced by social and environmental factors and by public policies that reach beyond access to and utilisation of health care.
Implementation of a cross-government ‘health in all policies’ (HiAP) approach enables interdependent and intersectoral strategies to promote and support individual self-care and a healthy population by addressing the social and economic risk factors that drive poor health.
Effective initiatives
Effective implementation of initiatives that promote health and support self-care through a HiAP approach requires committed leadership and processes that value cross-sector problem-solving and address power imbalances, siloes and boundary issues.