Dr Marie-Anne Essam is a GP in South Oxhey and is the social prescribing ambassador for the Herts and West Essex STP. Oxhey is an area of significant deprivation in South West Hertfordshire. She thinks social prescribing is the best thing to hit general practice in the last thirty years and here she tells her story.
“In the 30 years I have spent as a GP, social prescribing represents the most effective, wide reaching and life changing of all initiatives to date. Sometimes I have no idea what underlies a person’s repeated presentation to the surgery. Sometimes I catch a glimpse of one or two social determinants of health – like seeing the tip of an iceberg. The link worker spends time and expertise which I lack, to explore with the patients the rest of the iceberg, bit by bit.
“People are enabled to use the clinical services more productively, and make personal advances which are both transformative and sustainable.
“Networking and supporting community based resources is an essential part of neighbourhood empowerment, too. Social prescribing changes people and places for the better, and is a catalyst for effective commissioning and providing. It is such a privilege to be a GP at a time where we can appropriately “demedicalise” aspects of our NHS, and see resilience grow on an individual, an organisational and a societal level.”
Dr Essam talks about an elderly male patient who was social isolated and whose medical interventions were not improving his health. She referred him a local ‘care navigator’ who visited him at home.
Jim was a hoarder and his house was full of heaps of paper, boxes and rubbish. The drains were blocked, he wasn’t paying his rent and he had major problems with sanitation. The neighbours didn’t want to know him, and his sisters had disassociated themselves from him because he was so unpleasant and they felt powerless to help.
The care navigator discovered that Jim wasn’t paying his rent because he couldn’t find the landlord’s phone number – and this meant he couldn’t report the blocked drain. The phone number was eventually found under a pile of hoarded stuff, contact was made and issues were resolved. The care navigator helped Jim to clean up his house and then introduced him to a local community café, which he attended regularly.
Jim’s outlook and attitude improved significantly, which meant that he gradually began to make connections to the people around him. His neighbour let him hold her young baby and the next Christmas his sisters invited him to spend the day with them. They admired a blanket he had been given by a voluntary befriending service, which he then gave them as a Christmas present.
Sadly Jim recently died. But he would tell you – and his family and friends agreed – that the last two years were the best of his adult life. He felt better physically and emotionally, and found friendship and a sense of community that made all the difference to his later years.