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Gold, incentives and meh

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)

  • 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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