Trying to understand the language of person centred and community based approaches, asset and strengths based working, social prescribing and self-care can be confusing. But in the community of Woodley in Stockport they are just getting on with it, with a refreshing attitude rooted in common sense kindness. It was my pleasure to visit Woodley and meet Nicola Wallace Dean and Kay Ellermeyer, two women driven by a single purpose, to improve the wellbeing of people living in this area. Nicola manages Start Point Coffee Shop, Kay is the Practice Manager at Alvanley Family Practice.

This is a mindset; you can be overwhelmed by the demands in primary care and strive to keep it away or you can put your energy into finding the solutions through making use of the assets which exist in every community.

Patient Champions and Community Organising

So much of interest could be written about this collaboration between a family practice and a community hub. I could refer to the 20% reduction in GP surgery attendance felt to be attributable in large part to the ‘more than medicine’ alternatives on offer, many situated in the coffee shop. The recruitment of volunteer Patient Champions in the surgery to offer contact, support and activity to the more vulnerable and isolated; the Wellbeing Prescription developed and designed by the Champions for use in the Practice (see right); the creative use of social media including Facebook to spread the word. “Facebook offers us much more feedback and from a wider group of patients than any PPG we have tried to set up”- Kay.

And the Introduction To Community Organising courses run by Nicola for the Champions and anyone in the community who is interested, which stresses that simply listening to people and accepting their emotions will lead to action and change: “emotion after all contains the word motion”- Nicola. Examples of the way the community members come together to look after their own are heart-warming, with the Chatter and Natter Table and the Singing Group the latest addition to the menu.

Veg on Prescription

Instead I want to describe a more unusual form of social prescribing – ‘Veg on Prescription’. As with other community activities run at the Hub or through the Practice, there is no paid role for a Practice staff member here, no Social Prescriber, Health Trainer or Community Navigator so often found in such primary care led schemes.

Instead using a relationship with the Kindling Trust, Start Point member of staff Julie oversees a programme which builds on the research evidencing the benefits of Gardening to Health. Patients from the surgery agree to join the ‘Plot to Plate’ programme and in doing so can get their hands dirty growing food, sharing recipes, preparing, cooking and then eating together, using the collective enthusiasm of the group to support behaviour change. Entrenched thinking is challenged, for example the widely held view that a fish pie from a well-known chain supplying frozen food retailing at a pound is the only choice for people on very low incomes. Looking at the photograph of the two fish pies below and knowing the frozen one costs more, which would you choose?

Crucially this group is peer run, there is no expert in sight, no dietician or public health worker, no “patronising or intimidating” going on. Bags of veg are distributed each week in the coffee shop and surgery and the evidence is mounting, with one patient joking about his increased flatulence, but note no longer taking prescribed medication for constipation!

The key ingredients

What are the key ingredients? The willingness to see and engage beyond the surgery walls comes from this extraordinary family practice who readily see the benefits to people and workload from social prescribing the Woodley way. Reciprocity- the kindness shown in the surgery and in the coffee shop from the staff and the volunteers comes from a wish to give back. Certainly, the proximity of the coffee shop and the surgery matters, as does the sense of a community helping itself rather than relying on professionals and the ‘making every conversation count’ mantra – “If another 7-stone dietician tells me to lose weight I will tell them where to go”- group member.

However, above all this is a mindset; you can be overwhelmed by the demands in primary care and strive to keep it away or you can put your energy into finding the solutions through making use of the assets which exist in every community. Kay, Nicola and their teams have certainly shown the way.

This blog was written by Nick Dixon. Nick works within the Greater Manchester Health and Care Partnership to support more personalised health and care delivery. Find him on Twitter @NickDixon2