How Cake And Conversation Could Reduce Demand For Shaftesbury GP Appointments

Staff at Shaftesbury’s Abbey View Medical Centre hope to improve patient well-being through their newly launched ‘Health Champions’ initiative. Project volunteers have started working to address social isolation and potentially reduce the demand for GP’s time.

Alfred went to find out more, over a cuppa.

You can understand why patients sitting in the health centre’s waiting room on Tuesday morning were suspicious when they were offered tea and biscuits. We are frequently told about NHS cutbacks, so being poured a free cuppa seemed too good to be true. One woman, who was asked if she wanted a piece of chocolate sponge, asked whether she should make a payment.

(Left to right) – Judith Lask, Alyson Peacock and Jane Dawes

Practice manager and partner Jane Dawes was serving drinks from a sturdy tea trolley and handing out free slices of cake during the 4-hour event. This weekly tea service started last week and now runs from 10am to 2pm each Tuesday. Helpers offer patients advice, conversation and sweet treats as they wait for their GP or nurse appointments.

“They’re providing guidance, support and a friendly chat for anyone who would like to know what is going on in the local community,” explained Jane. The helpers can advise on support groups, self-help groups and activities, should patients wish to become more active.

The waiting room was considered the perfect venue. “There is a captive audience,” said Jane. “The work we’ve been doing is called ‘Altogether Better, Collaborative Practice’,” Jane said. The local Abbey View team has been working with the organisation behind this national project for eight months. The scheme has also been trialled in Canada.

“They try to rebuild connections in the local community and change GP practices’ relationships with their patients. The whole idea is to try to encourage people to look after themselves and to address loneliness, as well as the usual things we would be looking out for from a health perspective. By welcoming the volunteers into our practice, they become part of our extended team,” said Jane.

So far thirty helpers have signed up and Jane is looking to recruit more. Each volunteer has had an induction in the practice and every recruit has undertaken training. “They have all been DBS checked and they have signed confidentiality agreements. They know that what they see and hear remains confidential, unless the person gives them permission to pass that on to one of the clinicians,” Jane said.

Across Dorset, 21 practices are now signed up to this project. Jane says it is important that the Shaftesbury volunteers, rather than health service managers, determine how it evolves locally. “It is not for the practice to say what we need. It’s for the Health Champions to decide themselves. They live and work in the community and often know what is needed better than we do. They come with a whole set of skills and abilities. It’s tapping into that resource. They choose the groups they want to set up,” said Jane, as she outlined some of the activities planned for the surgery’s patients.

“We are starting a community allotment on practice land. It is in its early stages and will be for anybody who wants to get out into the open, get some exercise and who likes gardening. The produce will be available for any members of the community to use. We are looking at cookery lessons using some of the things grown and perhaps having a community lunch. We have ‘befriending on a bike’, too. One of our volunteers is a keen cyclist and would like to stop off to see isolated, housebound people during his 20-mile bike rides. He would have a cup of coffee and a chat with those people,” Jane said. A craft group is also on the cards.

The cake and biscuits being offered freely to patients in the waiting room were from a well-known supermarket’s luxury range – their posh selection. I asked Jane where the money for all of this was coming from. “At the moment, we are funding it ourselves as a practice. We recognise the benefits of engaging with our patients and having people coming to meet our Health Champions,” said Jane.

New food options will be added, following a conversation with a diabetic patient who couldn’t have cake. “We will have some fruit in the future, which is a slightly healthier option. There are also people who cannot eat at all. We will have a range of things going forward,” she said.

I can see how free cake could prove popular but there is a serious side to all of this. Patients locally and nationally often complain that they feel rushed during their GP appointments or they have to wait a long time to see a doctor in the first place. I asked Jane how this activity will address that common concern.

“Nationally, clinicians don’t add anything of value to 40% of their patients. People have needs that the medical model doesn’t meet. The idea is to put these people who are coming very regularly in touch with other people in the community. This will encourage them to get involved with other organisations or activities that improve the quality of life.” Jane offered the successful Shaftesbury Walking for Health group as an example. “The upshot for the practice is that it reduces the demand for services.”

Abbey View Medical Centre

That might explain why cakes and coffee, not a normal NHS clinical expense, can be funded. “Social isolation and loneliness are as much of a health issue as weight, alcohol and the usual things you’ll be familiar with. At first, you might think cake is inappropriate, but it encourages people to have a chat and facilitates conversations,” said Jane.

It’s a sad fact that some patients make appointments because they need social contact. Health Champion Alyson Peacock has volunteered because she can spare the time to chat. “It’s a shame many patients don’t get a lot of time with doctors. I thought it would be wonderful if they could just have someone else to talk to. When I got the message about Health Champions, I immediately thought that I wanted to do this. I don’t think that health is just the responsibility of doctors. I think it’s a responsibility of us all to help others,” she said.

Judith Lask was the second volunteer Health Champion on duty. Judith believes this new approach represents new thinking about healthcare. “We all like to go into our own doctor and we want to know them but that has changed because the demands for health services are great. The more needs that can be met, not just with the doctor in the consultation room, the better. It leaves more time for when we really, really need a doctor,” said Judith.

Judith’s professional life included time as a social worker and 30 years as an NHS psychotherapist. “I’m hoping to do some mindfulness connections groups. That will be to help people who have anxiety. I can do something about chronic pain as well. I’m particularly interested in helping with older people,” Judith said, adding that she considers herself as such.

She will address, “All the things that come with age, such as pain, discomfort, anxieties and worries. It’s going to be a mixture of light meditations, which are about relaxation, and feeling more in control of your discomforts and anxieties. There will be a social connection as well, which is always good,” she added.

Jane says there’s been quite a lot of interest in the new fibromyalgia chronic pain and chronic fatigue syndrome group which will meet monthly. “That is a monthly support group for people suffering from those conditions and at our first meeting, twenty people turned up,” said Jane.

Her social media posts promoting that service reveal that it will be in demand. She has received enquiries from outside the area. “I had one lady contact me from Shepton Mallet and a chap from Derbyshire wanted to know whether we’re going to do anything online, so that people who can’t currently access that support can get it. That’s something that we will be looking at with our health champions,” said Jane.

If you feel that you would benefit from that group, the next session is being held at the Abbey View Medical Centre between 11am and 2pm on 22nd November.

“This area of contact with patients, thinking about the whole person, is wonderful. It’s just where things have to go,” said Judith, during a brief lull from chatting with patients. “I’m very excited to be part of it and here from the very beginning. I think Shaftesbury is pioneering. Aren’t I lucky to be here at this time?”

I suggested that people will try to get appointments on Tuesdays knowing the cake’s on offer. “Probably, yes,” Jane laughed.

Health Champions isn’t a trial. Jane says that this service for Shaftesbury patients is here to stay. “This is very much a permanent arrangement, but it will be led and developed by the Health Champions and its frequency will be determined by them,” said Jane.