Analysis

General practice uses volunteers to help patients beat loneliness

A general practice is helping patients who may be visiting due to loneliness or other non-medical reasons with ‘social prescriptions’ involving volunteer health champions

A general practice is helping patients who may be visiting it due to loneliness or other non-medical reasons with ‘social prescriptions’ involving volunteer health champions


Activity groups run by volunteers include ‘veg on prescription’

Alvanley Family Practice in the Manchester suburb of Woodley works with a team of volunteers to provide a community-centred approach to patient care. Staff including GPs and the practice nursing team use ‘social prescribing’ as well as the usual FP10 prescription forms.

The scheme started after a review by the practice found 20% to 30% of appointments were for reasons where medicine would not help. Staff decided to tackle the issue by combining social prescribing with the support of volunteer practice health champions.

Cohort of frequent attenders

‘When we first introduced social prescribing we had a cohort of patients that as clinicians we knew would be ideal for support,’ says the practice’s lead nurse, Katherine Parker.


Katherine Parker with patient Harry Lewis

1.7 million

people volunteer for health and social care services across the UK

‘They were the frequent attenders who were coming in under the guise of medical reasons but it was really more for a chat to combat loneliness.

‘We can now refer patients to one of the social group options and provide them with a well-being prescription based on the activities they would like to become involved in.’

‘It is a great aid to be able to use as a practice nurse, as it is difficult in a ten-minute appointment to address what is happening with patients when they have issues over and above what they have come to see you about.

‘With the introduction of the well-being prescription, we feel like we are doing something to assist patients holistically, rather than just offering a medical solution. It is enabling us to take more appropriate action.’

Support for any patient

Alvanley was chosen as a case study for a recent report by think tank the King’s Fund on how volunteers can become involved in and contribute to general practice. The practice offers a range of well-being prescriptions for weekly activities led by the volunteers. These include health walks, ‘veg on prescription’, social events for new mothers, singing, ‘knit and natter’, and IT training.

While most of the activities take place in the community, the practice’s waiting room is the meeting point for the weekly health walks. The health champions also provide telephone support at the practice. Three champions come into the practice once a week to call a selected group of patients for a general chat. This support can be arranged for any patient who is feeling isolated and would appreciate a call.

‘Becoming a community-centred general practice and offering social prescribing has meant that our list size has grown by 15%,’ says practice manager Kay Keane. ‘We have also seen attendance drop among the top 30% highest-use patients and this has enabled clinicians to increase the time they spend with patients who have medical needs.

20%

of a GP’s time is spent on social problems that are not principally about health

Source: Citizens Advice

She says: ‘Social prescribing has improved the care we give to patients. The prescription looks just like an NHS one and it gives validity to the recommendation a patient receives from a GP or practice nurse that it will help them in the same way a prescription for an antidepressant could, for example. It is helping patients to make new friends and establish community links.’

Building the team

Facebook is an effective way for the practice to keep in touch with patients, and the introduction of the popular health walks was the springboard for interest in other activities. The practice worked with the organisation Altogether Better to recruit and train volunteers to become practice health champions to help provide the well-being prescription options. The practice now has 21 such champions.

‘Patients are no longer saying they cannot get an appointment,’ says Ms Keane. ‘They are more likely to ask now whether we offer a veg on prescription scheme.’

Four approaches to patient engagement

The King’s Fund report, Volunteering in General Practice: Opportunities and Insights, highlights the ways in which volunteers can be involved in general practice and identifies four approaches that could be adopted. These are:

  • Enabling general practice – volunteers are engaged in roles that support the practice with its day-to-day functions or with activities such as greeting and supporting patients at the surgery or providing an outreach driving service to help people attend the practice.
  • Shared premises and space – working with organisations that engage volunteers in providing services. For example, using practice space to run satellite services or using a community venue to deliver health education activities.
  • Social prescribing – a way of linking patients in primary care with sources of support in the community.
  • Community-centred general practice – a unique model of general practice that reflects social as much as medical needs, and where volunteers engage in practice activities as well as providing activities built on their own skills to benefit the practice and community.

Role of volunteer health champions

Practices ask people on their list and from their local community to become involved and receive training as health champions. So far, since 2014, Altogether Better has recruited, trained and supported over 18,000 volunteers as community health champions. The role of each volunteer varies depending on their interests, experience, and the needs of each practice and local community.

‘Champions give whatever time they can based on the skills and interests they have,’ says Alvanley practice manager Kay Keane. ‘Two patients came to us wanting to volunteer who were worried they did not have traditional skills but they could play the guitar and piano.’

Benefits for patients

‘They now lead our popular weekly singing session that takes place in a local café. It is always a case of standing-room-only and they sing a wide range of songs. We have seen benefits for patients with long-term lung conditions because the regular singing is helping to increase their lung capacity,’ Ms Keane says.

‘We also offer a "knit and natter" option on the well-being prescription. The idea for this came from one of our champions who meets a couple of friends every Saturday to knit and chat. They were happy for others to join them and the weekly knitting session has grown from there.’

Making it to the top

David Ashton is a patient at the practice who has severe chronic obstructive pulmonary disease. ‘He was on a palliative pathway essentially and he was anxious about exercise,’ explains practice manager Kay Keane.

‘He knew being active could help him but he did not feel confident in his own body to manage walking. He is one of our regulars on the weekly walk now. When he was a teenager he walked up a big hill to see Manchester airport in action for the first time and the memory has always stayed with him.

‘He had expressed a wish to his wife to spread his ashes at the top of the hill as he felt he would not be able to get up there again. However, three weeks after he had joined us, he attempted the walk to the top of the hill, reached it and saw that view again.

‘There is no way he would have done that without the support from our weekly walking group.’


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