Hello, I'm briquette Ash and welcome to how Healthcare happens brand new podcasts from Cardiff and Vale University Health Board all about how the NHS Works in this episode. We're out in the community. We paid a visit to Lansdowne surgery in Canton in Cardiff the chat with one of their GPS. Dr. Karen Pardee. Karen is a GP, but she is also the lead for social prescribing for the whole of Cardiff and Vale, uh be and that's what we popped into chapter about we talk about some of the examples of social prescribing in her area of Cardiff some of the examples that have stood out to her from across the region how and why why can make a difference to people's lives and some of the outcomes that she's already seen you may have seen the news that Karen was part of the team involved in the next bike on prescription ski in Cardiff that launched a few months ago, but there is more social prescribing than just next bikes. In fact, there are dozens and dozens and dozens of opportunities for people to get engaged in the communities in various different ways. I even up to carrots opinion on the type of social prescribing that she would recommend for me the answer to which I'm genuinely interested in we discuss all that and more coming up. Today's guest is dr. Karen Pardee a GP at Lansdowne surgery in Southwest Cardiff. Hi Karen. Hello. I think most of our listeners are probably familiar with what a GP is but maybe not all of them will know everything that the GP does so to begin with. Can you just explain that part of your role? Essentially GPS are there to provide holistic care for patients? So we see all patients from when they're first born, right? You to the end of life and we basically support them with all of their needs that they have during that time particularly as GPS were also very interested in health promotion and not just seeing people when they're ill I like to think of GPS as the connection that people have with the NHS in their local community and I suppose that is kind of what you just described. They're a constant. They're always there and people can go and talk to them about more or less anything when it comes to Health you mentioned holistic care and that's kind of what I wanted to talk about today in that part of your role is the lead for social prescribing at Cardiff and Vale University Health Board. This might be a big question. But what is social prescribing it's a very difficult question to answer and I think social prescribing means a lot of different things to different people. But essentially it's all about linking people in with their community. What's going on in their community that can help support them particularly with their non-medical needs is GPS with very highly trained to help deal with people's medical problems, but often not so were highly trained to do it help deal with some of them or social problems that people face and inevitably everybody has a number of needs which can be medical psychological or social and all of them are very intellect with each other social prescribing is really about trying to find that support for people. People more looking at their social needs than their medical needs do people come into the practice with social problems, or do they come in with a what they would think as a medical symptom that you could identify as related to something else. I think it's quite a mixture the a figure that's often quoted is that 20% of people come to their GP for non-medical needs, but I think it's not always so easy to Define it as that. Sometimes people do come with social needs. Because they don't know where else to go and you mentioned before that GP is very much that constant in the community and it's a very trusted role and people do come to their GPS about all sorts of things. So it's not always directly Medical but very often it is very much interlinked with their medical problems, but we obviously recognize that some of these social problems have a big impact on their medical needs as well. Are you able to tell me some of the examples of the types of social problems that you've attended to? But there are a great many but I supposed to sort of things often relate to things like housing or debt or employment or lack of employment, but it's certainly not restricted to those. That's just a few examples. There's a great almost Limitless number of things that people might come and talk to us about even with those examples that you've just outlined I can see how it could affect your health in the long term through stress. You had problems with your housing and you know that could affect your respiratory condition. If you've got damp or something like that then if you didn't know where else to go the GP would seem like a logical. Yes Port of Call. Absolutely. Yeah, I guess another big example is social isolation and that can affect people's mental health a lot. And I think that's something that we look to support people with quite a lot through social prescribing helping to reduce the isolation link people in with others in their community. And that in turn has health benefits for them is social isolation a problem that you see a lot in Cardiff it is this it is seen a lot. Yeah. Yes among all groups of people and I think often we think particularly of elderly people living in their own home maybe not able to get out so much. They can be quite isolated. But all sorts of people can become socially isolated and it's probably a bit of a factor of living in cities as well where it's probably more. And why more prevalent in cities traditionally, the more rural communities are closer and people know each other better, but it's not always the case in cities. So I think it can be that people can become more isolated in cities. Yeah, I can understand that as well. I'm sure a lot of our listeners can sympathize. So from what you're saying. It sounds to me like the role of the GP is changing from one that treats purely medical needs to one that as you say can take a holistic approach to different needs that people have social prescribing is the toolkit that GPS have to treat these needs. Although having said that I think GPS have always really had much more, you know had a holistic approach, but I think we're just getting many more tools now to support us in helping people with these needs traditionally. We may have just kept a little notebook with a few names of key organizations that we happen to know about but I think we recognize that that Obviously isn't consistent across all GPS and and also we can't possibly keep track of the number of organizations that there are hoping support people in their community. So I think social prescribing is really trying to make it more effective and more accessible for everybody. One of the things that we've spoken about in a previous episode. That's just come to mind is something called Health Pathways. Yes, and I know that you were quite heavily involved in health pathway. Yes. Yeah. That's right. Do you think in The future social prescribing might feature on that. I certainly hope so. Yes because Community Health Pathways which are guidance to help GPS refer people to the most appropriate source of helpful them and that's not only secondary care or other Healthcare organization, certainly social prescribing forms part of that. So I'd very much like to see fantastic. Do you find that in your role as a GP when you prescribe someone one of these activities or Services that were talking about. Do you see a reduction in their attendance to your surgery or do find that you're prescribing them fewer medications? Is it having that sort of impact it's something that we're in the process of formally looking at to try and get some data. I mean anecdotally I can certainly tell you that I have had patients who have prescribed various activities and certainly their attendance of GP surgeries as a result. All of that has been a lot less because they're finding that support in the community. And also just some small pilot studies we've done we have seen a reduction in prescriptions as well particularly looking at things like antidepressant prescriptions, but we're in the process of trying to formally evaluate and to actually get some evidence behind that but it is something that I would say. I've definitely seen and seen people benefit from if you follow that logic then if people are benefiting from In the community, that means that they're much less likely to be admitted to hospital perhaps. Yeah. Absolutely. Yes, and that is one of the the key outcomes that we're hoping to see is that we will be seeing people who are supported and cared for close to home and with a reduced need to go into hospital if it's avoidable obviously hospitals are still always going to be needed but it's about trying to provide that that care and support for people close to their home. Yeah. Let's just focus on on one small example is a small example. It's one of the largest issues facing Health in the UK and that is slips trips and falls. If a patient came to see you and you were worried that they were at risk of falling is social prescribing something that you would consider selling would consider it. Yes, and there are a lot of community organizations that are providing the sort of strength and balance type exercises. I mean Tai Chi is a prime example that's becoming increasingly popular in that. Really helps to support people in those sort of activities that help to prevent slips trips and falls. So yeah, there's certainly a lot going on that can help and support people because obviously one someone's had a fall if they're elderly chances are they'll be admitted to hospital for absolutely days and something that I never realized before I started working for the NHS is how quickly your life can change when you are admitted to hospital. Yeah. Absolutely. Yes. Yeah, very very Very big changes happen, particularly and thinking about elderly patients if they're immobilized for a time than that can have a big impact and on confidence as well, which is another big factor in people's Independence when they come home again. Can you give me any other examples of the types of things that you're prescribing people? Well, I think so people is one of the key projects that we have in our cluster is a gardening project called the grow well project and we set it up in collaboration with a local charity and it's run by a therapeutic Gardener who supports people who come along to the gardening sessions and we as GP practices within the cluster will prescribe. Pull to go along to those sessions and we've seen huge benefits to the people who come along to those sessions and it's not only for the people who come but also for the community around us. We've got a one of the gardens is here at Lansdowne surgery. We have schoolchildren who passed by in the morning who pop in with their families to it on their way to and from school and it just promotes a really positive and healthy message. I think for people what sort of thing. Are you growing in the garden? So it's growing all sorts in the garden. We've got small apple trees. We've got he's lettuces flowers. We all sorts of things and all the produce obviously, you know, our volunteers will take but also people passing by will just come and take the produce as well. And that's part of the reason for having the garden is promoting healthy eating. I assume you give it away for free. Absolutely. Yes, so it's really opening up the Let's see if healthy food for people in this local area that may not be able to afford it. Otherwise again, yeah, absolutely. Yeah, so we're recording this podcast in October 20 19. Yeah, I guess you've just had your Harvest for the year we have yeah, although things do happen all year round here. We've got a very talented Gardener and he just wanted to keep things going. All right all year round. But yeah, we have had a harvest recently. Yeah, so you mentioned a term when you're describing the garden and that I'm not sure. Everyone will be familiar with and that is the cluster. Can you just explain that very briefly clusters were formed around five years ago and they are aligned to the local Authority areas boundaries and they're called Primary Care clusters. And these are groups of services within a community who are joining together to help to provide the best services within that community. So Example and the lead for card of Southwest cluster and we have 11 GP practices within our cluster, but it's certainly not only GP practices that form the cluster. We've worked very closely with third sector organizations and with other Community Health and Social care as well as other community health providers such as our community pharmacists optometrists and dentists and it's about all of us working together in an integrated way and helping to to provide the best services for the people within our community the tend to just be GPS that engage in Social prescribing or do those other Healthcare professionals have access to it as well very much other Healthcare professionals, and we've done a lot of awareness and training within our cluster. So all of our reception staff and all of our Health Care staff are all trained in Social prescribing, but we're also now looking at moving more widely. We've got some Community Navigators who we work with and they're very much now going out into the community and looking at training up anyone really in Social prescribing so we can all help to support each other within the community the role of the community Navigator sounds really interesting and it's one that I have not come across before you say they work out in the community training people are training people in Social prescribing. Yes, who were they training at the moment they are looking to train particularly. People that maybe work more sort of within Healthcare settings, but they would go out and train for example even people in shops or community centers and we're looking to really broaden their roles so that we can involve more members of the community and are they part of the GP practice or a part of the Pista? They're part of the cluster. I mean again different areas do social prescribing in very different ways and within our cluster. We have we work closely with a third sector organization and they have Community Navigators who work very closely with the GP practices, but also with the community as well fantastic. So as I mentioned at the start of the podcast, you're the lead for social prescribing for the whole region that is Cardiff and Vale of Glamorgan through the health boards primary community and Intermediate Care team other than the work that is going on in your cluster. In and out of your GP practice, are there any examples of social prescribing in Cardiff and Vale that really stand out to you certainly in the range town area. They have health promotion fares there and I did see recently there was one that was took place in a mosque all around health promotion, which is particularly supporting the minority ethnic population in those areas. So that certainly stands out in other areas in the north of Cardiff where there's more of an elderly A population there's a lot of social describing which is relating to people with dementia and their carers and carers are people that often have a lot of social needs and become quite isolated. And so social prescribing is an ideal way of providing support for them looking at the Western Veil again, they've done a lot of work looking at supporting people with dementia and also they're doing some work looking at more rural communities so we know one of the biggest issues facing Healthcare in the UK at the moment is sedentary Lifestyles and obesity. We recorded an episode with dr. Tom Porter the other day and he told us that over half of all adults in Cardiff and Vale a classed as overweight or obese with a fair amount of adults also clusters said entry in that they do less than 30 minutes of exercise every week can social prescribing begin to address this issue. Yeah, most. Definitely. Yes, and we do see There's a lot of people that won't want to go to a traditional exercise class or a gym or a swimming pool, but we'll go to a walking group or come to a gardening project or you know, take part in activities where perhaps the prime reason isn't to get exercise. But exercise is part of that particularly in sort of social groups like a walking group. And the other thing that social prescribing can do is to help support people that maybe we can't access the more traditional forms of exercise and one example of that is in one area of our cluster with setting up walking groups for women because certainly some ethnic groups where women will only take part in women-only activities and So that obviously helps to support them and helps them to get physical exercise. So I think social prescribing can play a big part in that fantastic if someone wanted to get involved in these Groups or activities it's not like they need permission from their GP to get involved is it it's social describing is linking people with what's already there in the community. But also it's looking for gaps so that if there is something like a walking group for women and we identify that something that's needed. We can look at how we can set that up. But no, it's definitely not something where they need a prescription for it's really just about linking people up with what's there and what's happening. Anyway, is there some sort of central database? S of voice things that you can get involved in if you're a resident in Cardiff in the Rain, the daoist website is very good source of information and we'll have a lot of this information there, but we're also looking at setting up a social prescribing platform which will be across the whole of Cardiff and Vale and that'll be a way as well that people can link in and find out what's happening locally within their own community and how they can help to get involved and access those things great. Now just out of Interest. I was just wondering if I were one of your patients and I came to you what activity would you recommend for me? So bit about me in my mid to late 20s. I'm not as active as I could be I have asthma I like to be social but don't always find the time and say all of that was starting to get on top of me a little bit. What would you recommend? I think I'd probably recommend something which has elements. And of volunteering in it because volunteering is something that you can do which can help link you in with a lot of activities such as you know, involving physical exercise which are communal so you get to know other volunteers as well. And there's a lot of evidence around the health benefits of volunteering and how that can help people's sense of well-being. So I think I'd probably be looking for something with a volunteering element in it. Something like good gym would be very good. Good gym. Is a an organization where people will meet together as a group will do some exercise from which I understand is usually running and they will then run to a project where they can help to support people whether that's mowing somebody's lawn or helping move some furniture or decorating and then they all run back again. So there's volunteering it's helping to support people and also a communal activity where you're getting physical exercise sounds great. Great. I might actually look into it. Okay. Talk to Karen party. Thank you very much. Thank you. Thank you again to dr. Karen party GP at Lansdowne surgery and the lead for social prescribing a Cardiff and Vale University Health Board. What a fascinating chat and really interesting opportunities for people living in not just Karen's are of Cardiff, but I think all over the city as well as develop Morgan is clear how these interventions can make an impact in people's lives, especially when we think about reducing the risk of people being admitted to hospital. Although it's not conventional. Medicine it seems obvious that people should be supported to be as healthy as they can in their communities, whether that's through taking prescription medication or through activities, like walking gardening cycling and socializing if this can keep them healthier for longer than out of hospital and that is a huge win. Not only for them, but for the NHS as well, if you have a topic that you'd like us to cover or someone that you'd like us to interview, please let us know you can email me at news at whales that NHS dot u k or contact me on Twitter. Twitter @ CV underscore, uh be please remember to like And subscribe to this podcast and leave a review if you can I'll just help us spread the word about all the good work that the NHS is doing until next time. I'm bring kentish and this was how Healthcare happens
How would you feel if you visited your GP and they prescribed you a cycle ride or a bout of gardening? Social prescribing is a way for GPs, nurses, and other primary care professionals to offer people a range of activities and services instead of, or alongside, prescription medication. It's revolutionising community care in southwest Cardiff with other great examples across the city and in the Vale of the Glamorgan, all of which aim to keep people healthier for longer in their homes and communities. Leading the social prescribing agenda in Cardiff and Vale UHB is Dr. Karen Pardy, a GP at Lansdowne Surgery in Canton, Cardiff. Karen kindly agreed to chat to us for this episode to highlight some of the great examples of the work that she and her team are doing and ultimately, it can keep people from being admitted to hospital. Bryn even asks Karen for her opinion on what type of activity she would recommend for him! If you're interested in some of the opportunities that we discuss, you don't have to have a referral from your GP, you can visit the Dewis Cymru website for an idea of the services and groups that might be in your area. 