We are living fewer years in good health: Is the NHS part of the problem?
Some doctors are testing new approaches to see whether changing the way the NHS works can lead to better health. Dr David Blane is a GP at Possilpark in Glasgow and academic lead for GPs at Deep End, an organization run by doctors in Scotland’s poorest communities.
Patients in these neighborhoods often develop multiple long-term diseases 10 to 15 years earlier than patients in wealthier areas, he says.
“Not only are you more likely to have longer-term health problems, but there are other things in your life that affect your mental health – a lot of low mood, depression, chronic pain… These have a huge impact on your quality of life, your sense of self and your sense of purpose.”
One of the roles of GPs at Deep End is to pilot new strategies to reduce inequalities in healthcare.
One strategy was to extend all appointments to 15 minutes. “This definitely helps with empathy. It helps with potentially managing multiple issues in one consultation and also helps with GP stress,” says Blane.
But he argues that the most important factor is continuity of care, that is, consulting the same clinician each time. “Continuity of care saves lives and can also help ensure better access, better follow-up and better health outcomes,” he says. “For the last 10-15 years, the political emphasis has been on fast access. [to treatment]”That’s important for some things, but not for everything.”
Blane is also helping to assess new family welfare support workers in Glasgow. These staff connect patients with money counseling, housing assistance, trauma counseling, language support, and physical activity programs. The model creates a “sticky” interaction between people who might otherwise leave the system, he adds, and can be replicated in families across the country.
