Look Who’s Talking Dr. Marie-Anne Essam
The ‘Godmother of Social Prescribing’
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I am constantly amazed and delighted by the changes I see when my patients return to me, very evidently more confident, proactive and happy in their own unique life contexts. Dr. Marie-Anne Essam
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’ve been a GP for 30 years, and for the last 15 years involved in trying to integrate care around patients. People’s health is dependent, however, on a lot more than the clinical aspects and the help provided by many separate bodies. 70 years of medicine, free at the point of access, has inadvertently overemphasised the importance of what doctors can do, and has resulted in individual and organisational behaviours which need to change if we are to enable people, families, communities and nations to live their lives as well and fulfilled as possible. People tend to have multiple obstacles to being well. There are historic and generational obstacles to personal freedom and quality of life. As a GP, I meet individuals and whole families who have often been unable to progress for years.
They often appear powerless, frustrated; have dysfunctional relationships, experience poor mental health, lack employment, stability and have a tendency towards health harming habits. Social Prescribing gives a fresh opportunity to find a way out of these negative and toxic mind-sets, behaviours and circumstances. When meeting with these individuals and families, the first wider health factor that becomes apparent could be housing, neighbours, debt, isolation, poor physical fitness affecting long term conditions, stress related to their role as a carer, or poor mental health often not given a definitive diagnosis by psychiatry. Someone with a long term health condition may be unable to change detrimental lifestyle habits, despite doctors’ advice and even referrals. As a GP, whilst I may recognise these problems, I am not best equipped to deal with them. I don’t have the expertise, resources or time needed. Much effort has been previously exerted by staff kindly phoning around, trying to help in a crisis, with varied success. However, there is no capacity to provide the appropriate follow through and support. Sometimes patients just come frequently to see a GP because non-medical issues, even hidden from view, are robbing them of being well. Let me introduce you to the Link Worker: They have the time, the expertise and the resources which my patients need to find the personal motivation, courage and strategy to improve their well-being. By intuitive, non-judgmental listening, establishing trust and effective communication, the Link Worker provides what for some is the first opportunity to move from a very difficult and damaging place, to one where they are motivated and supported to make sustainable progress. A plan is co-produced in the context of this mentoring relationship according to the patient’s preferences and priorities.
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