Reflections on WHO Classification of Self-Care Interventions webinar - 3/3. “Self Care and a new era or culture of healthcare”
A growing group of patients, professional regulatory bodies and health care professionals are seeking a new culture of health care – transparency and aco-production of health and healthcare.
During our work on the Self-care and culture change of the UK NHS Electronic Record Development Implementation Pilot in 2001 our project was analysed and recorded in an MSc thesis by Samina Munir, overseen by Professor Ruth Boaden. (Culture and change at Hadfield Medical Centre”.) The comments seem to encapsulate the changes envisaged by the WHO Self care classification.
Samina and Ruth quoted Burnes‘ analysis of culture as “as “*the particular set of values, beliefs, customs and systems that are unique to that organisation*” stating that Burnes (2000) describes emergent change as:
- A continuous process of experimentation and adaptation aimed at matching an organisation’s capabilities to the needs and dictates of a dynamic and uncertain environment.
- Change is a multilevel, cross-organisational process that unfolds in an iterative and messy fashion over a period of years and comprises a series of interlocking projects.
- Change is a political-social process and not an analytical-rational one.
- The role of the manager is not to plan or implement change *per se*, but to foster an organisational structure and climate which encourages and sustains experimentation, learning and risk-taking, and to develop a workforce that will take responsibility for identifying the need for change and implementing it.
Ruth and Samina went on to write:
“Many different and varied models describing organisational culture are available. Of these, a model was chosen that best reflects the purpose of this report and best describes the organisational culture at the HMC. This model is that of Cummings and Huse ((Burnes. B. (2000), *Managing Change – A Strategic Approach to Organisational Dynamics *(3rd edition), Pearson Education Limited: Essex)
1989), who describe culture as 4 elements existing at different levels of awareness within any organisation. These levels are:
1. Basic assumptions
2. Values
3. Norms
4. Artefacts
It seems that the development of mobile technology is creating the artefacts that are necessary to support the emerging change of healthcare basic assumptions, values and norms of health care. The basic assumption of the patient as a passive passenger and object is hopefully going to change and the patient will have a much greater value as a team member. The patient will increasingly be allowed to use as many of the knowledges and skills of the professional staff as they can safely employ. More “work” will be shared, delegated to patients but not abdicated, towards a partnership of shared responsibility.
References and useful links:
WHO health topic page on self-care interventions:
https://www.who.int/health-topics/self-care
WHO Classification of self-care interventions (2021):
https://www.who.int/publications/i/item/9789240039469
WHO Guideline on self-care interventions for health and well-being
(2021): https://www.who.int/publications/i/item/9789240030909
WHO video on Self-care interventions to support UHC and PHC (2019):
https://youtu.be/hwGPJDQNyoo
For any request please send us an email to: selfcare@who.int
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HIFA profile: Richard Fitton is a retired family doctor - GP, British Medical Association. Professional interests: Health literacy, patient partnership of trust and implementation of healthcare with professionals, family and public involvement in the prevention of modern lifestyle diseases, patients using access to professional records to overcome confidentiality barriers to care, patients as part of the policing of the use of their patient data
Email address: richardpeterfitton7 AT gmail.com
