The times they are a changing… it seems our much-troubled NHS and related social support networks can no longer rely on existing operating models to meet and successfully manage or solve the growing burden of chronic diseases and as such different strategies are now underway.
The biomedical model that dominates medicine has its limits and it’s clear that evidence demonstrates marked inequalities in related healthcare access and outcomes as well as worrying statistics about declining life expectancy in several high-income countries.
One strategy that has received considerable attention is ‘social prescribing’, which has been described as a way of linking patients in primary care with sources of support within the community to help improve their health and well-being[…]. Schemes commonly use services provided by the voluntary and community sector and can include an extensive range of practical information and advice, community activity, physical activities, befriending and enabling services. Social prescriptions have been used in healthcare systems worldwide for several decades because they are thought to promote wellbeing, prevention and self-care and recently the NHS has set out to create a network of link workers in primary care networking teams to assist with the delivery of this proposal.
The NHS is looking to incorporate a process that permits the development and implementation of personalised care which, they hope, represents a transformative relationship between people, professionals and the health and care system. It should provide a positive shift in power and decision-making that enables all people to feel informed, have a voice, be heard and be connected to each other and their communities, if it works.
One service that is evolving alongside this is ‘Health Coaching’, a personalised approach based upon behaviour change theory and is delivered by health professionals with diverse backgrounds, including Nutritional Therapists. Within the NHS there are ‘health coaching’ roles, both within primary care and acute settings. NHS health coaching differs from social prescribing in that emphasis tends to be placed on the behaviour change, rather than connecting people with community groups and services. However, there are many similarities, as a motivational coaching approach is an integral part of a social prescribing link worker role.
Where do practitioners with a strong background in nutrition and possible functional medicine fit in, do you for instance see a future being part of the NHS structure, sitting alongside it or operating independently? The evolution of medicine, run by James Maskell has recently (Dec 19) appeared in Birmingham, where he met with Dr Asfia who has been pioneering an organisational change in Birmingham, involving community change, and the integration of differing professions and great food. Learn more about this in James’ new book, called the Community Cure and we recommend that you add this to your new year’s reading list.
In Jan 2020, Clinical Education will also host the next Prescribing Lifestyle Medicine master class where almost 200 GPs and medics have already booked, to join the 800 plus who have already attended this RCGP approved one-day course. From this, many spin out developments have occurred and represent the early shoots of optimism in health delivery and sustainability.
One of the great challenges for the intersection of social, biomedical and psychological interventions in a single delivery point is that it is generally too much for a single person to manage. Working in teams makes sense but delivering a working structure of this to scale it up, still eludes many, confuses others and feels unachievable.
It is of course a challenge, one of many, and the beauty of functional medicine is that at its core is an organised approach to data collection and translation to intervention. By using a common language, interdisciplinary approaches can be built, teams can operate in collective wisdom, whilst still providing levels of specialism and clinical care can be personalised.
2020 is the start of a new decade, by the time we get to the end, the delivery of health care in the UK and elsewhere will be radically different to today, but it will not be genetics that dominate, it will be the integration of human needs into a lifestyle driven approach to self-management and care. Where will you fit into this mission?