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General Practice improvements to social quality of life Dr James Fleming. Solutions to unemployment and isolation when no other agency can help. Aim. A Story.
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General Practice improvements to social quality of life Dr James Fleming
Solutions to unemployment and isolation when no other agency can help Aim
A Story • Patients who others could not help - isolated, long unemployed, furthest from labour market, agoraphobic, clinically dependant, excluded, low self-esteem • I treated the medical problems, but this was making them ill. • Was there a role for me to do more? • Further learning and information gathering • Finance • Individual tailored care • Marry health/social needs • Community Development
Case example • 30 F‘Am I depressed?’ Wants sick/fit note • Tearful, rock bottom, drinking • Rent arrears, debt, poor housing • Little self-esteem, not worked for years • Stuck where she is, can not see a future • Repeated attendances at GP, little progress
Present care • Do nothing, give differing advice, ‘not my job’ • Anti-depressants, anti-anxiolytics • Tell to go to JC+ – sick note? • Present self to alcohol services • Citizen’s advice • Contact health visitor for support • Counselling • Personal reckoning – hope for the best
Why this is not working - evidenced • Unable to navigate services alone • Worries about not getting money • Requires deep understanding of self • Requires confidence • Peer pressure • Unable, unwilling to travel • No reference • Can’t manage the transition, no-one has time
Green dreams approach in detail • Send from GP, motivate, believe • Identify barriers to increased QOL • Contact JC+ for financial stability, go with her • Liaise c landlord, HMRC, DWP, Welfare Rights • Involve in one of our projects, build confidence • 3rd sector, Stubbylee, CVS, mapping, overlap • Complete documents, correspondence, CV • Access Training and coordinate • Lifestyle and health issues
Social Isolation • Bingo, venue, machinery, self funding now • Day trips – self funding (Hawes, Skipton) • Meet old friends, laughter, dress-up • Now, never comes to doctor • Also, home visit, befriending, fitness, craft, voluntary organisations, walks, computer, procure space, Art Group, Theatre Group, Knit and Knatter