While GP caseloads continue to grow across Scotland, a number of initiatives spearheaded by health boards, surgeries and charities have sought to try and find solutions. Could doing more of this work? The Ferret looked at the evidence for three different approaches.
In West Lothian, NHS Community Wellbeing Hubs have been set up in Livingston and Bathgate to provide multi-disciplinary support and resources to people with mental health difficulties such as stress, depression and anxiety.
NHS therapists work alongside community link workers from local charity Lanarkshire Association for Mental Health (LAMH) to provide holistic and tailored support ranging from therapy to self-help and clinical interventions. In their first six months of operation (June to November 2019) the hubs supported 836 people, although the direct impact on GP caseloads is unclear. Those accessing them are still required to be signposted by a GP in the first instance. Updated data is not available.
A 2020 Scottish Government report set out principles for the delivery of mental health services in primary care and the community, with funding made available for these services. A number of similar hubs are currently in development including in areas of Glasgow identified as particularly deprived, such as Govanhill and Springburn, but no date has yet been announced on when they might open.
The Ripple is a charity, based in the east of Edinburgh, which works to tackle poverty and inequality within the local community. Alongside the Edinburgh Health and Social Care Partnership, The Ripple has established a Catch Your Breath group for those with long-term lung conditions as well as offering regular exercise classes for all abilities.
Last October it launched a weekly outdoor swimming group which it says is aimed at promoting wellbeing and helping people feel good in a way that’s “free, accessible and local” with a low impact on the planet. The group meets at Portobello beach to swim, but aims to go further afield in the warmer months. Once a month the charity invites a doctor from the local GP practice to come too, aiming at helping the group to build trusted relationships with a doctor.
Meanwhile Chest, Heart and Stroke Scotland’s health defence team provide a range of services from free health checks to physical activity sessions, both in person and online. The charity has opened two “health defence hubs” in Glasgow’s Drumchapel and Maryhill neighbourhoods, which can be accessed on a drop-in basis or via an appointment booked online.
Anyone attending will have their blood pressure, weight and cholesterol levels checked and support and advice on healthy living will be offered. Activity sessions from chair-based activity to circuits and healthy walks are also on offer. Those outwith Glasgow can request a phone or zoom call to discuss their physical health and mental wellbeing.
Some GP surgeries themselves have tried to tackle the problem of increasing caseloads, including by extending their opening hours. Earlier this year, NHS Lanarkshire announced that a number of its surgeries would open on Saturdays throughout January, when demand is usually high.
However, weekend opening was previously included in the 2015 Conservative Party’s Westminster manifesto and met with mixed response. A 2015 study from the universities of Oxford and East Anglia found that weekend opening was unlikely to be enough to meet patient needs, with lead researcher Dr John Ford explaining that a “key problem is that many practices do not currently have capacity to provide weekend opening in addition to weekday services.
“This means that a reduction in weekday services would be necessary – which could actually reduce access for patients who find it easier to see their GP during the traditional working week,” he said.
Cover image thanks to Karolina Grabowska/Pexels
GPs in Crisis is an investigation by The Ferret examining the pressure on doctors and patients at the frontline of community healthcare. Support our journalism by becoming a member for £5 a month at theferret.scot/subscribe.
This story is part of our Health Gap project, funded by the European Journalism Centre, through the Solutions Journalism Accelerator. The fund is supported by the Bill & Melinda Gates Foundation.