GPs often find that patients come to them with problems that are not medically based. These problems are sometimes referred to as psychosocial problems. Examples are difficulties with housing, family matters, frailty, abuse, as well as loneliness. Although all of these things impact on a person’s health and can make simple medical problems much worse, there is often nothing a GP can do, especially if they only have 10 minutes with the patient.
Sometimes a GP might not even know what is going on in someone’s life. It might be because the patient doesn’t want to bother the GP with these things, or maybe the patient doesn’t think that anything can be done or that they don’t deserve support. Sometimes patients are ashamed or embarrassed by such things as smoking, or excessive drinking or eating. It is well accepted that people who are suffering abuse often hide it from others. For some that cultural stiff upper lip makes it hard to actually ask for help and support.
However, a new initiative called Social Prescribing is coming to Romney House Surgery; it will make a world of difference to many patients, and to their GPs too. Social Prescribing is about connecting people with supportive services that are non-medically based. We are pleased to be welcoming Lisa Hepworth who will be taking on the role of Social Prescriber under the direction of Sarah Clifton-Gould and the Social Prescribing Hub. She will be with Romney House Surgery one day a week, spending the rest of the time with other surgeries in the South Cotswolds. This initiative will be funded partly by Gdoc, a company set up by the GPs of Gloucestershire to bid for and administer funding from the Department of Health, as well as Cotswold District Council.
Social prescribing is a new way of doing things, and the best way to understand it is to use an example. Derrick (not his real name) is 75 (not his real age). He has arthritis (not his real condition) and has been caring for Deborah, (not his real wife) who has dementia, for several years. During this time they have lost their social circle of friends because Derrick has been so busy caring for his wife. Finally Deborah’s dementia has progressed to the point that she needs full time nursing and has moved into a nursing home.
Derrick now finds himself living alone for the first time since they got married. His own arthritis, probably made worse by his time in the army and his career as a gardener, is taking its toll and he is struggling to care for himself and his home. He doesn’t want to move as it is the only place he has lived and it has so many fond memories of the years that he spent there with Deborah. It is also close to the nursing home so that he can visit there daily.
During a visit to the GP he finally mentions some of these difficulties and the GP refers him to social prescribing. He has an appointment with the Social Prescriber who takes the time to listen to all aspects of his life, not just the medical problems. They find that the house has fallen into disrepair and this overwhelms Derrick. He also mentions that walking to the shops is starting to become difficult as he has been struggling to cut his toenails and his feet are becoming painful. He is worried that this means he won’t be able to walk to see Deborah every day.
The social prescriber spends time with Derrick just talking, not just about his immediate needs, but about his life in general; what his interests are, about his past, and his worries for the future. This isn’t about offering a set list of things available; it is about putting the person in the centre and tailoring solutions specifically to them.
They identify not just what support he needs, but what his goals are as well. They get in touch with the British Legion as he is ex forces, which help with the repair of the house. They also help him apply for Attendance Allowance, and invite him to a social gathering of ex-servicemen so that he can rebuild a social circle. The Social Prescriber also puts him in touch with a the Foot Health Care service so that he can have his nails cut, which keeps his feet healthy and pain free so that he can continue to walk to the nursing home and the shops. They also put him in touch with a Men’s Shed where Derrick can use the skills he acquired as a gardener to help others.
This example is a mixture of several different real life situations. But it is not just the older person that can benefit. Young people can be referred too. Social prescribing can help people navigate benefits, respite care, and general support.
In areas where this has been done before, they have found that people use less painkillers, there is less depression and they don’t need to visit the GP so often. People’s lives have been turned around so that they become less dependent on their GPs and happier and healthier. This can keep people in their own homes in the community longer, which is not only cheaper for the NHS and social care, but much more pleasant for the person.
Some of the services they will be referred to are traditional and well established ones, but they will also refer to small local community support as well. To make sure that referrals to these smaller organisations are safe the Social Prescribing Hub will be supporting them to have their services Kite Marked. This will give both the referring GP and their patient confidence in the service.
There are things that we can do to support this. The PPG have already made a list of local groups and services for Tetbury that the GPs have been using. This will be handed over to Lisa and she will make sure that it is kept up to date. But initially they may not be aware of all the groups locally that operate, so if you know of a group that have something to offer email the PPG at romneyPPG@cyberbarn.org.uk or leave the information in the wooden box by the PPG notice board in the surgery waiting room.
And if you feel you could benefit from Social Prescribing, or know of someone who would, do speak to your GP or one of the practice nurses. You have nothing to lose, and every thing to gain!
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