The Frome Model of Enhanced Care is a GP focussed, community serving and using way of creating, assessing and delivering comprehensive health and well-being skills, services and attitudes, in, with and for a community, at a low to negative net cost. Its administration is remarkably inclusive, heterarchical or flat.
It is so attractive that it merits awareness, analysis, adoption and adaption to spread its remarkable and measured attributes.
It has delivered 5 years of medical care with social cohesion. It saves money and is more enjoyable! Somerset CCG reckons some £2 million saved. Hospital admissions have gone down although admissions rose in the rest of Somerset. There is a dedicated website and the positive use and filing of e-mails, phone calls etc. The surgery uses its database and print-outs to avoid referral forms and avoidable delays and uses statistics to gauge starting points and outcomes. Time, including that for relevant conversations is costed.
The belief and enthusiasm of “outreach” staff is such that they carried on working during a three month gap in pay.
Frome is small enough to innovate: large enough to make a difference.
Frome is a lively market town with a strong street market focus with an independent council which has part funded this project and encouraged it. It funds training for volunteer “Community Connectors” who are vital for the project/team- over six hundred of them. The project is helped by the building of a new surgery next to the hospital. The centrality of the surgery has facilitated outstanding medical conversations, record connectivity and a secure medical-legal base.
The watchwords are, “Practical, Emotional, Medical, Social”. There is a keen consciousness of the dangers of “Silo Attitudes” with a systematic primary care focus which is holistic, collaborative, “whole population” focussed. There is an energetic awareness and use of social and familial contacts.
The medical impact of isolation is the equivalent of smoking fifteen cigarettes a day.
Most support comes from social connections which improve patient care AND paid and volunteer carers’ enjoyment. Group cohesion and one to one working are paramount. For all involved a major tool for connection and function is conversation. There are three paid outreach persons/recruiters/”fixers”. Recruiters include streets and supermarkets in their “territory.” There are strong connections and shared plans with State and voluntary organisations such as C.A.B. Making lives feel and be worthwhile is paramount. There is “Talking Café” for social contact/conversation: the shy have volunteers for introductions and support. All the connections link across society and status.
Care is done with the person, not to the person.
There is a policy of assertive gap filling in the activity network. For only one patient a “Parkinson’s Club” was set up and became a national leader!
The interconnectivity of groups and their connections with the GPs creates awareness, drive and efficiencies. It encourages confidence and reduces “zero risk cultures”. The “whole-team approach” empowers patients/supported people and staff.
The power of relationships, including professional and volunteer home visits is developed and used for the evident benefit of the cared and the carers!
See Dr Helen Kingston’s account here: Frome, an experience of building a more compassionate community.
* Steve Trevathan is chairperson of Lyme Regis and Marshwood Vale Liberal Democrats.