The COVID-19 outbreak is unlike anything we have experienced before, and many people are understandably struggling with the rapid changes it has made to their lives. My practice, like others, is overwhelmed with calls from patients who simply have nowhere else to go. They need help but don’t know who to ask. Some are scared after receiving a Government letter saying they should be shielding, others are suffering with anxiety or depression, some are victims of domestic abuse or substance misuse, whilst many are struggling financially during the lockdown.
People are reaching out for help and support, but many do not have a medical need and don’t need to see a GP. Community connection – or social prescribing as the health and care response has become known – is just as valuable now, as it’s always been.
At Alvanley Family Practice we have access to 16 link workers who are playing a vital role in our response to COVID-19. They have coached our receptionists on the different options available to patients. Those without a medical need are signposted to the link workers, or other community support, which is helping to reduce the pressure on GPs.
In the early days of our COVID-19 response we informed our link workers which patients might need more support during the current crisis. These were patients on the Government’s shielding list, those who were vulnerable, isolated, who were struggling before lockdown or where we had other welfare concerns.
Our health care assistant contacted all our shielded patients sharing a separate phone number for them to contact the practice during opening hours and the details of the COVID-19 mutual support local group details. These groups have grown up all over the country and have really helped to support general practice. Our local group is made up of volunteers who will collect shopping, prescriptions and have regular telephone calls with those who are feeling isolated or lonely. The efforts of the volunteer group have allowed the link workers to focus on other vulnerable patients with more complex needs.
COVID-19 is bringing new challenges in terms of how we support people. Social prescribing usually focuses on face to face contact, connecting individuals physically into their communities to tackle some of the causes of ill health. We must now rethink how we can support people at a social distance, or virtually. How do we help them to stay connected, keep active and eat healthily when they can’t meet up at coffee mornings, join a walking group or attend cooking classes? We have to be flexible and agile to help our community reach those who are house bound.
But we have risen to the challenge. There are a wealth of innovative ideas and clever solutions coming from link workers and social prescribing teams across Greater Manchester. I have heard of a community music group doing a session over skype, volunteers making calls to isolated and lonely patients, the usual weekly walk being replaced with an online dance session, and people accessing community groups by phone. Of course, there is also a need to train people in how to use the internet differently and this is being tackled by providing tablets and technology coaching, sharing guides on how to use Zoom, and setting up a virtual ‘communiversity’ for people to learn new skills.
This outbreak is an endurance test for us all, whether we face stress and pressure at work, financial hardship, loneliness and isolation, anxiety and depression, or the loss of a loved one. But if we look for the silver lining of this particular cloud, we can see the green shoots of some really positive change. In my own practice community, there are amazing acts of kindness happening all the time. Making these community connections, being good neighbours and helping others with social and practical support is vital to our health and happiness.
We need to capitalise on what’s going on in our communities. If we can do this, together with continuing to strengthen the national and regional structures supporting link workers, then I think we will be able to sustain this social movement in the long term. The informal WhatsApp groups should continue, the mutual aid groups set up in the face of COVID-19 must be maintained, and hopefully volunteers will continue to help their neighbours and wider community. I believe we are starting to turn back time in terms of our communities and returning to that sense of being a ‘good neighbour’ that I remember from my own childhood in Old Trafford.
As GPs, the current crisis is forcing us to learn and adapt more rapidly than ever before and is a reminder that our patients have challenges that we as GPs can’t treat in isolation. My hope is that practices will forge stronger links with their local communities and learn how to work more effectively in partnership with them to support the health and wellbeing of their patients. After all, community connections are vital to supporting our patients holistically and keeping them safe and happy.
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A proud Mancunian, GP Dr Jaweeda Idoo was born and raised in Old Trafford. She has worked with her husband, at the Alvanley Family Practice in Stockport, for over 20 years and has a passion for people and communities. She is also the Chair of Stockport’s GP Federation, Viaduct Care.