Enabling Health and Wellbeing in Later Life – new report from IHW on a system that links older people to local community resources through their general practices
The Enabling Health and Wellbeing in Later Life Project aimed to develop a system (BRIDGE – Building Relationships In Deprived General practice Environments) through which general practices in deprived areas can identify older people in need and help them access resources and/or participate in activities known to help prevent or delay disablement and enhance wellbeing.
We used participative methods with staff in general practices, community organisations and older people to understand, co-design and ‘road-test’ the system in 3 stages, including a knowledge exchange event.
The likely ‘active ingredients’ of a general practice based system included: a) Identification of a practice based link worker; b) Active identification of people in need; c) Building relationships with community service providers; d) Providing older people with up to date information about services; e) Supporting older people to engage with services; f) Feedback and follow up.
Practices, older people and community organisations easily made sense of BRIDGE, knew what they needed to do and maintained their enthusiasm and commitment throughout the project. However, they were hampered by the time available and the relatively low availability, accessibility and suitability of community resources in deprived areas. Practices had time to find and contact only a few local organisations, with variable success, in terms of their attraction to older patients. With more time, all practices felt that these links could be developed.
Improved linkage of practices to community assets is not a system that can be “switched on”, with large numbers of patients being processed from the outset; rather, it is a complex system, comprising many relationships which need building up over time, based on experiment and shared learning. Many of these links are horizontal, working across organisations. Allowing these links to develop organically through building relationships is likely to be more successful than a vertical “top-down” approach. If implemented in this way, BRIDGE has considerable promise.