Unique GP mental health service providing 'better for less'

The success of a pioneering project in Bradford that helps GPs to support patients to improve their mental health and well-being is demonstrating the strength of innovation in approaches to healthcare. By Judy White.

Bradford District Care Trust’s health trainer service manager Nurjahan Ali Arobi with GP Dr Clare Connolly

Bradford District Care Trust’s health trainer and social prescribing service, which brings health trainers into surgeries to work with patients, has proved hugely popular with GPs and patients alike.

It was set up to develop a non-clinical approach to helping people who visit their doctor regularly as a result of low level mental health problems, social problems or isolation and loneliness, putting them in control to find solutions.

Working across 21 GP surgeries in south west Bradford, social prescribing health trainers have up to six sessions of up to an hour with a patient. They listen and use problem solving methods, including developing personal health action plans, to help patients find a way forward. Patients are then referred to a community or voluntary organisation for further support if necessary.

GPs have welcomed the initiative for its ability to give appropriate and quality support that responds to myriad social issues. Patients have praised the service for the friendly, informal support from people who have time to listen. There has also been significant anecdotal evidence that many patients saw their GPs less as a result of using the service.

The project is unique in combining the expertise of health trainers, who work in a variety of settings to help people to improve their health, with social prescribing – a new approach in primary care, which promotes the use of the voluntary and community sector to help tackle health, well-being and social issues.

According to an evaluation report carried out by Leeds Metropolitan University, investing in the service has the promise of not only saving money, but of improving the range and quality of what primary care can offer to patients – in other words providing ‘better for less’.

Dr Clare Connolly, of Bradford’s Horton Park Surgery, said: ‘It is a chance to help people solve problems which are causing them distress as opposed to masking the 'pain' with antidepressants. It is also accessible because the patients are seen in our surgery and this reduces the stigma of mental health issues.’

Bradford District Care Trust’s health trainer service manager Nurjahan Ali Arobi explained: ‘GPs come across psycho-social issues all the time but, with all the other demands they face, they rarely have the time to get to the root causes of the problems.

‘The health trainers can really get to know all the factors affecting someone’s health and have time to accompany them to community groups if they find the prospect intimidating.

‘It’s often very practical. For example, some people can’t face turning up to organised physical activity on their own so if that’s what they need, the health trainer can help by introducing them, and they’ll go back again to check that they’re still OK.’

The approach has been very effective. The evaluation report recorded a wide range of positive health and social outcomes, including helping people to return to work after an illness or accident, to lose weight, to join support groups and to take steps to deal with anxiety.

The evaluation report, which used information from 22 interviews, states that social prescribing health trainers offer a service that makes a positive difference for patients and practices at a relatively low cost.

It says that more than half of the 484 patients that used the service made personal action plans to tackle their problems, with 87% of those making progress on these during the period under review.

Judy White is strategic lead at Yorkshire and Humber Regional Health Trainer Hub.

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