Following a stimulating visit to a city-based community farm the day before, the journalist travelled to a more rural area to meet Cleo – a doctor at a community practice known for its innovative approaches to health challenges.
A day in the life of Cleo
When he entered the practice, he met Cleo and a team of five nurses in a clinic that contained three medical examination rooms, the reception area, an office space and lounge area for the staff.
The journalist was keen to know what made this clinic so different to the others he had visited on his European journey.
Cleo responded, “Well, a lot of our work deals with public health and prevention. One example is our work with schools, as we used to see so many kids under ten with cavities and poor dental hygiene.
“Several times a year we visit schools and work with the teachers to find fun ways to teach kids and their parents the right way to brush teeth. It’s a simple intervention, but we collaborate with the two dental offices in town and so we know it’s effective. Engaging with the children at their own pace and in ways that they can relate to have been important strategies.
“We also have a programme to support parents, and particularly pregnant mothers, with nutrition and access to healthy, affordable food – sometimes connecting them with cookalong clubs or food co-ops. We listen to the challenges that people face – which might be money, time, fussy eaters, allergies – and find solutions that can work for the whole family.
“Although the visits are only a small part of our work, it has been rewarding to see a decline in the number of children coming in with basic, preventable health conditions. This gives us more time to deal with more challenging health cases, and it feels like we’re building a closer connection to our community.”
Sharing is caring
“Another initiative we have successfully implemented focuses on reciprocity – capturing the enthusiasm of many recovered patients to ‘give back’ to services that supported them. The programme allows previous patients to help current or recovering ones – for example those leaving hospital who may not yet be completely independent.
“For those where practical and emotional support cannot be provided adequately by friends or family, our programme can help. Regular visits from a previous patient who has undergone the same thing helps manage isolation during recovery. Practical support lets patients recover faster with less worry about tasks such as cleaning or shopping.
“This approach, building on the successful Helpforce programme, has been instrumental in enabling nurses and other staff to focus on duties where their competencies are more acutely needed.
“It’s an optional programme, but many former patients have themselves thrived on the reciprocity and love it so much that they have become permanent volunteers in the programme.
“It works because we are constantly listening to what our patients and volunteers need, so we know how best to use their skills and benefit from their ideas.”
Relating and tuning into systems
“Another important programme we run has been inspired by Hilary Cottam’s Wellogram Programme.
“Like other social prescribing models, it’s for our patients who suffer from a complex range of social, emotional, economic and physical ailments that cannot be solved in one doctor’s visit.
“We have trained ‘listening’ workers who take time to meet with these patients to simply listen and understand their challenges and needs – and the barriers that may be blocking good physical and mental health.
“A plan is then decided together, to be worked on at a patient’s own pace, which may or may not involve medication. Other options to combat loneliness, increase exercise, provide more access to nutritious food or help solve financial or emotional anxieties can be equally important.
“This programme also works to build trusted relationships, support continued good habits, and combat the social isolation that underpins so many problems. Being patient-led is a key ingredient.”
Supporting patients to take active steps towards healthy lifestyle changes was not only empowering, Cleo explained, but was effective in reducing patients’ ailments. “I feel immensely proud to have seen the changes over the past fourteen years that have successfully tackled some of the issues related to low incomes, poor diets and limited access to or confidence around healthy food and lifestyles.”
The journalist asked how people on low incomes now had access to nutritious food. Cleo replied that many community-led initiatives had highlighted the health issues of a food system where cheap junk food dominated less affordable fresh, whole foods.
The response, backed by communities and public bodies, was to encourage and support more home growing, more community allotments, and increased investment into organic farming. Initiatives to support both community and commercial farmers to secure a decent income from sustainable practices had also flourished.
“And how are all these programmes funded?” the journalist asked. It seemed to him that such programmes would require a lot of funding and resources, and where had that come from?
Cleo explained that all medical services in the local area shared an allotted health care tax, but just sharing out the money hadn’t been enough to guarantee effective responses. So they had decided to collaborate, to refer patients across the different services, to support and learn from each other’s innovations, and take the best practices forward.
In addition, the programme’s focus on reciprocity, volunteering and learning actively saved money that could then be invested in other programmes, as well as delivering social and well-being returns.
Drawing on personal experiences
Intrigued by what he had heard, the journalist asked how Cleo herself had ended up trialling these programmes.
“Well, as a kid I looked after my younger brother a lot,” Cleo said. “Which ended up being my entry into care. He’s blind and so needed a lot of assistance. I learned to simply listen to him, to understand the challenges he was facing, his need for emotional support and the best ways to help him. I realised that I enjoyed it a lot and it let me be closer to my brother.
“Later, I found a medical degree that looked at new ways of managing public health services. There were three mandatory internships as part of the programme, so I learned from different practices. I was also lucky enough to travel to different parts of the world that had innovative social health care programmes, where I either volunteered or was hired for entry level positions.
“When I came back to Wales I was eager to experiment with several of the models I’d seen and experienced, and I was fortunate to find a practice already involved with social prescribing and community connectors. By collaborating with others in the region, we have developed more activities and programmes – and here we are!”
The next week we introduce our last but most important character of all, Gwen-Eddo, a local wellbeing-of-future-generations officer.
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