This is England

09.07.14

There was an article on the radio this morning about the growing problem of loneliness experienced by an ageing population. An example was given of an elderly lady who had not been out of her house for months and was on anti-depressants until she discovered a local lunch club; first she became a user of the service and then a volunteer – she is also now off anti-depressants. The person running the club pointed out the savings to the state as well as the improved quality of life of the older lady. The article finished with a government minister urging more people to get involved in combatting the loneliness of older people.

However, what if the problem is not with the number of people willing to support such clubs and groups but is with the NHS itself?

There are hundreds, thousands of such local groups across the country (usually staffed by older people themselves). Action Hampshire did a short survey, a few years ago, identifying over 700 of them in Hampshire alone. These groups have a workforce, almost exclusively, of volunteers and require tiny amounts of public support (usually a few hundred pounds at most) to exist. Their work is “preventative” that is it helps to improve the quality of the lives of its client groups and it keeps them out of those much more expensive services (in terms of the cost to the public purse): doctors and hospitals. However, in our experience, few clinicians in the NHS yet recognise their effectiveness and even fewer are prepared to provide financial or other support to them. Responses that we have got when trying to explain how a strategic recognition of these services could lead to substantial reductions in NHS spending, have ranged from “that’s just not going to happen” to “well, it depends how you define prevention”. As we cannot provide clinical proof that an intervention such as a lunch club increases the health & wellbeing of its users, clinicians seem to feel justified in largely ignoring it as a way to deal with this growing social issue.

In some parts of the country it is different, social prescribing pilots are being undertaken, usually leading to a growing recognition of the effectiveness, both in terms of mental health and cost, of these non-medical interventions. In Hampshire as well there are early signs that some CCGs are starting to explore the resources on their doorstep afforded by local voluntary and community groups. Southern Health has also been working with lunch clubs, eg Age UK Winchester, to provide services.

However, until the NHS systematically and strategically recognises it, the problem will get bigger and the costs will continue to rise – however many people get involved.