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GPs to help elderly patients at risk of loneliness under new pilot scheme

GP practices will be asked to pilot a 'low cost' programme of intervention for older people who are lonely, under a new scheme that public health chiefs hope to roll out nationwide.

Public Health England said that its Behavioural Insights Team has developed a new intervention, drawing on what has worked well in previous trials, which it hopes to pilot in GP practices across Greater Manchester this year.

Under the plans, GP practices will be asked to identify which older patients may be at risk from social isolation and loneliness and 'help them through provision of services', PHE said.

PHE said that although 'evidence is still limited for effective interventions to tackle social isolation and loneliness', it is known that it 'substantially affects morbidity and mortality'.

It refused to clarify exactly what GPs will be asked to do, but said the social prescribing programme should not 'burden' GPs, it said.

A spokesperson said: 'The Behavioural Insights Team at Public Health England, along with partners, have designed a low cost, scalable and evidence-informed intervention to reduce social isolation and loneliness and have been given NHS ethics approval to run a pilot.

'We aim to use efficient processes that do not burden the GP to identify older people in primary care who are at risk of social isolation and loneliness and help them through provision of services that draw on the best available evidence of "what works".'

He added that PHE is 'in discussion with general practice in Greater Manchester to pilot this during the 2016/17 financial year', with the aim 'to determine feasibility and to inform future testing of intervention effectiveness'.

Dr Des Spence, a GP in Glasgow, and a tutor at the University of Glasgow, said: ‘It sounds like a good idea but I don’t know that it is a good idea necessarily. I think that kind of falls beyond the remit of doctors. There are so many of these initiatives and they just don’t work in my experience.

'Loneliness I would have thought is a major social issue, it is not a medical issue and I just don’t think healthcare is necessarily the right agency to be responsible for that.’

He said ‘there’s a conveyor belt’ of these ‘well-intentioned good ideas’ being rolled out to GPs in Scotland as well but ‘often what happens is that they get rolled out, there is lots of hype around them for a month or two and then they quietly are shelved, as they make little impact’. 

The rise of social prescribing

gardening 3x2

gardening 3x2

NHS England's GP Forward View raised social prescribing as one route to manage patient demand on GP services, and a recent King's Fund report said GPs should prescribe gardening to patients with conditions such as heart disease and dementia.

But GP leaders have expressed differing opinions over the role of social prescribing in general practice, with some arguing it provides GPs with alternative routes to manage patients who do not need traditional care and others branding it 'a waste of time.

Dr Arvind Madan, NHS England’s Director of Primary Care, has said that the 'ambition is that, eventually, every practice will have access to all the initiatives in the GPFV', including social prescribing options.

Readers' comments (27)

  • GPs ideally placed again,these ideas should get 2 fingers rampant,unfunded social services or charities would be better placed to do this.

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  • I would code it as 'LONELY PATIENT', it takes a second. and let social services pick it up. No more, no less. DNs would be better placed though.

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  • After Loneliness of a Long Distance Runner, the next work should be
    'Loneliness of a GP'
    Is there anybody out there with a hint of sympathy for the profession or are we supposed to be burdened with all ills of society?

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  • Unassisted hearing loss is an important risk factor for social isolation and loneliness as well as cognitive decline in the older population. If this is suspected, onward referral to audiology should be automatic.

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  • How many extra services are GPs supposed to provide with little or resources?

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  • Peter Swinyard

    Let's get this straight. They are not "lonely patients in primary care." They are lonely people living at home. In 1971-3, I was part of our Community Service Group at school and used to visit the lonely and isolated elderly. Not hard to find. Grateful for a friendly face for a couple of hours a week. Nothing to do with my job as a GP, sadly, as I cannot cure a society that warehouses or ignores its elderly population. At a time of 25% vacancy rates, I don't think this initiative is appropriate. Hand if over to the Schools Minister and get them to get on with some proper social cohesion measures.

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  • We are a fractured society and there is a lot of loneliness amongst health care professionals as a well as over-regulation.

    I used to cover acute geriatrics but was told that I should not spend too much time talking to my patients.

    Humanity and respect is part of the caring professions but I do understand my limitations and that of the system.

    I do not think social work are able to deal with the issue, perhaps Age Concern.

    As for mental health, statistically young men in this society are most likely to kill themselves and usually quite a violent manner.

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  • the logic seems to be that 'any' issue can lead to a 'health' problem and since GPs deal with health problems then they are ideally placed.

    where does it end?

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  • Another crap idea from people who has nothing else to do.
    This is nothing to do with Clinical Medicine. Social services/ Age concerns can deal with that.

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  • Fortunately we have a surplus of GPs and not enough work to do, so what a wonderful opportunity for us all, ideally placed as we are, to be a waste bin for all of society's problems and dump-box for every well meaning half-wit to unload into.

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  • yes I agree with above, we are all so bored and under-worked at the moment we would all relish the chance to take on some more unpaid work

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  • Clearly a thoroughly well planned idea which is so good that GPs in greater manchester have not been informed of it until now, through the national media.

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  • In the latest edition of Commissioning Review Mike Dixon says (I think) a lot of places are doing it so it must be a good idea...!
    If this is what Commissioners think and how they act on evidence then no wonder we are in such trouble

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  • bring it on as it adds to the overall misery and will be helpful in pushing folks to the exit only then will we be able to rebuild a proper service.

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  • I have a headache

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  • We found Prime75+ project reduced consultations. Lifted morale. Very popular across the practices. http://goo.gl/25AH0m

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  • Could this just be yet another 'Revenue; Stream for the Private Companies running our Public Services?

    Turn the Lonely into a lucrative commodity?

    They rip up our Communities and our Families.
    Strip away support services and buy up the Charity Sector, offering buck with conditions often of silence.

    Now its time for the elderly.....

    And to use GP's as the middle man is disgusting.

    Seems to me they are designing a Complex Control System by stealth.

    I don't trust anything this Government Suggests.....

    Overwork GPs.
    Create constant change and Chaos.

    Then come up with ways to alleviate the burden...

    Stinks of manipulation and coercion to me.

    This is how Totalitarian States gain more control over the proletariat.

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  • Took Early Retirement

    Presumably GPs should do it between checking on people's boilers and making sure they are not a risk of radicalization, and, indeed, problem gambling.

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  • This comment has been moderated

  • Is there any wonder med students don't want to be GP's?

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  • GP's are best place to replace befriending services.

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  • No resources, so No. We can only just about cope with the present work load - with partners retiring even that is becoming impossible.

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  • As GPs we are index are of how many of our elderly patients are lonely. In the past I used to encourage them to attend some of the very good local day centres in the area. But these were closed down due to cuts, Some were demolished and land sold to property developers for flats. There are few services for lonely old people. There are charities but they don't have many resources. It's very telling that the article doesn't mention what we are supposed to do as GPs for these lonely old people. And the fact that they admit there is no evidence base for this initiative. I like the weasel words " evidence informed" as opposed to "evidence based". Do they think we won't notice? I know what needs to be done to help the real problem of loneliness in old age - restore funding for social services, which has suffered a real terms cut of about 20% in funding for the elderly, and restore grants and support to charities.

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  • Sorry for typo in first sentence of my comment. (Annoying predictive text!) I meant to say "As GPs we are indeed aware of....."

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  • Let's be positive. For a start we could all wear dickie bows.

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  • To be fair, I don't the people floating these sort of ideas realise that General Practice is in terminal decline. The slow death of Primary Care may be obvious to the few GPs left, but has barely been mentioned in the mainstream media. Once the remaining partners in the 50+ age group escape, the whole structure will collapse.

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  • Could some old folks perhaps befriend some lonely GPs who have lost all their colleagues at work perhaps? It might be nice to have a batter with someone other than a patients for some singlehanded doctors.....it's just a thought.

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  • The stats are that around 15% of doctors are themselves clinically depressed I think befriend a GP scheme would be a good idea. I have has quite a few discussions with doctors as to their preferred route of ending it. He said he would not attempt to cut his wrists without Elma cream I declined to assist but kept a watchful eye on him.

    I do not say this to detract from the loneliness of elderly but it is a social problem and may of course have clinical implications upon mental heath and prognosis.

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