(Frome) How a family doctor in Frome, Somerset, weaved a net against loneliness by mobilizing people in her town
Frome (pronounced Froume) sounds like something out of an Agatha Christie novel. We can easily imagine Miss Marple arriving on a foggy morning to investigate the sordid murder of a local notable. With its five churches (the oldest dating from the year 685), its main street that winds through old stone buildings and its quaint shops, it’s the kind of place where people greet each other in the street and meet at the pub to drink a Guinness. Less than two hours from London by train, it’s no surprise that this small town on a human scale nestled in the heart of a constellation of villages and hamlets attracts Londoners in need of space, greenery and community spirit.
Less famous than its neighbor Glastonbury, home of the well-known music festival, Frome made headlines in 2018 not for its tourist attractions, but for the feat of a family doctor who pulled off a veritable tour de force: reduce emergency room visits by 14% compared to an increase of 28.5% in the rest of the region. Everyone wanted to know how she did it.
“My goal has never been to reduce emergency room visits,” says Dr. Helen Kingston, who greets me in her large, bright office. The Frome medical clinic, which employs about 100 people, is a 10-minute walk from the main street, in a brand new building, next to the hospital and bordered by a vast ground for cricket, the national sport of the English. .
What interests this very empathetic family doctor are not so much the statistics, but the well-being of her patients. And Dr. Kingston sensed that that well-being came through an even tighter-knit community.
Dr. Kingston also noted that the patients who came to see her most often were not necessarily sicker than the others. They felt alone and they needed to talk. “Everyone is so busy and running around,” she observes. Simply stopping to chat with someone is seen as a waste of time in our busy lives. Above all, we don’t want to disturb our daughter, our brother, our friend… Not to mention the automation that reduces the number of human contacts in our days. »
The family doctor therefore tried an experiment. With a modest grant (approximately $140,000), she hired a woman with long service in community health: the dynamic Jenny Hartnoll. The latter made an inventory of all the community organizations in the region to create a computerized database accessible on the computers of all physicians.
“If I have a patient who is suffering from a non-medical issue such as loneliness, recent bereavement, housing issues…I can talk to them about this organization that is out there that might be able to offer some help. support,” Dr. Kingston tells me. The idea is to consider the person as a whole, not to sum it up solely to his illness. »
But British family doctors are no different from their Quebec counterparts: they, too, are overstretched. Dr Kingston’s accomplice, Jenny Hartnoll, has therefore set up a small group of liaison officers who take care of this follow-up for the clinics in Mendip, a district of Somerset. Those who are called “health connectors” here, but “social prescribers” elsewhere in England, are in a way the missing link between the medical world and the community world.
“Our agents work together with the home care team, with social workers and doctors,” explains Julie Carey-Downs, who leads the small team of health connectors at Frome Medical Clinic. “Before, I was a psychiatric nurse. In my team, there is a former teacher, a former pediatric nurse, etc. What unites us is this desire to support people in their quest for well-being. »
Frome’s stroke of genius is to have also mobilized its population of approximately 27,000 inhabitants. “We thought, why don’t we train ‘ordinary residents’ to be transmitters of information, too? says Jenny Hartnoll, who is also a consultant with the National Academy of Social Prescribing.
Barbers, police, supermarket employees… Since 2013, Jenny Hartnoll has trained more than 1,900 citizens in the region. “These people feel like they’re part of the solution,” adds the dynamic 40-year-old encountered early in the morning in the cafe at the Black Swan arts center. The residents of Frome also owe him weekly coffee meetings and a talking bench located a few steps from the municipal library. “An idea I had during the pandemic so that single people could have a meeting place,” she says.
What distinguishes community liaison officers from health connectors who work in clinics is that health connectors are paid and even have access to patients’ medical records! They can look at the doctor’s observations and add their own, like, “Madame X feels lonely, I told her about the coffee meetings.” Mr. Y’s wife has Alzheimer’s, I suggested she call this support group. “What makes our approach so successful,” Dr. Kingston assures me, “is the fact that these agents are integrated into the medical team. No one works in silos. »
Richard Whitehouse can’t remember who he learned about the Men Shed, one of the many community organizations in the area. Perhaps by one of those famous agents trained by Mrs. Hartnoll? Still, a few weeks after settling in Frome, where he moved with his wife to be closer to their family, Richard joined this group of men who meet once a week to do odd jobs, work with wood and … to break the loneliness.
Their premises occupy two floors in a building a little away from the village, which also hosts a women’s group, the Women Shed, which his wife, Rosaline, has joined. “It speaks a lot more to women than to men,” the latter confides to me, laughing. And conversations are more personal. »
The men, more silent, carry out small jobs for the community such as these birdhouses that the City has ordered from them. “These men have worked their whole lives in the factories, they’re retired, and for some of them the Shed is their only way out,” Richard tells me, not very vocal himself. As this message scribbled on the slate hanging on the wall of the large workshop says so well: “Cheaper than an hour of therapy…”
And it is in this way, by tightening the meshes of the community and by accompanying her patients in a quest for well-being, that Dr. Kingston and her team have succeeded in reducing the number of visits to the emergency room. Frome’s approach, dubbed “compassionate communities,” has been seen around the world. The New York Times, BBC and The Guardian, among others, came here to interview the family doctor who also hosted a delegation from 10 Downing Street (the address of the British Prime Minister).
Dr. Kingston also received the Points of Light Award – which recognizes people who make a difference in their community – from then-Prime Minister Theresa May. Several countries, including Australia, have been inspired by Frome, and Jenny Hartnoll, much in demand to give talks, tells me that she has been in contact with people in Canada, in British Columbia in particular.
Can we import this approach, developed in a small village, to a big city like London or Montreal? “Absolutely,” Dr. Kingston tells me with conviction. Each big city is divided into districts which are also like small villages. Anyone can take our template and adapt it to their community. »
