Objective: Health and self-care education to 5- to 11-year olds is key to disease prevention and health promotion. This study aimed to evaluate how self-care education is delivered to primary school-aged children in England. Design: Non-participant ethnographic observation. Setting: A sample of primary schools, extracurricular clubs and religious schools in England. Methods: In-class observations were undertaken in primary school settings and textual narrative synthesis was used for analysis. Results: A total of 11 teaching sessions were observed. Self-care topics were covered in subject areas including science, physical education and personal, social and health education lessons. Healthy eating and nutrition, physical exercise, mental health and hygiene were key areas covered. While the sessions emphasised the importance of healthy behaviours, the link between healthy behaviours and health promotion was not always apparent. Methods of delivery varied considerably across educational settings. Conclusion: Strategic policy adjustments are recommended to establish a standardised curriculum for the delivery of self-care education, thereby fostering equitable opportunity for learning. Further emphasis on self-care in the context of disease prevention, health promotion and management of minor ailments is needed.