Loneliness and social isolation increase the risk of developing frailty; 10% of people over 65 years have a degree of frailty (Davies et al, 2021). People living with a degree of frailty are at higher risk of health problems, such as cardiovascular disease, lung disease, obesity, fractures and depression (Turner, 2014). In people aged over 65 years, hip fractures alone cost the NHS over £2.3 billion a year (NHS England/NHS Improvement, 2022). The NHS Long Term Plan (NHS England/NHS Improvement, 2019a) highlighted that personalised care can promote and support wellbeing and overall health outcomes. The plan emphasises the importance of a person-centred holistic approach, focusing on physical and mental health issues, while supporting people socially.
Social prescribing involves signposting people to a variety of local area-based services that can support them to become integrated into their community. It is made up of many different community and voluntary organisations that provide a wide range of services to match each individual's interests, such as gardening projects, information on becoming a volunteer, befriending services and education services (Buck and Ewbank, 2017). Some argue that there is not enough evidence on the effectiveness of social prescribing (Husk et al, 2019). However, NHS England/NHS Improvement (2019b) disputes this and has set out six key principles as a guide for a comprehensive personalised care model and believes working with trained social prescribing link workers is imperative. The six key principles are shared decision making, enabling choice, personalised care and support planning, supporting self-management, having access to personal health budgets and, finally, social prescribing and community-based support.
How can loneliness and frailty deterioration be prevented? The NHS Long Term Plan identifies a key component to achieving this is the implementation of primary care networks (PCNs) (NHS England/NHS Improvement, 2019a). PCNs are networks of health professionals working with groups of GP practices to provide integrated personalised care to the local population. PCNs can support people with more complex needs, they provide anticipatory, proactive care and have the ability to offer a range of interventions. They give people improved access to services and support them physically, mentally and socially. PCNs signpost and refer people to relevant services, offer face-to-face assessments, using shared decision making to determine individual's needs.
Studies show that social interactions lift mood and alleviate depressive and anxiety symptoms (Min et al, 2016). Focusing on social and mental health concerns can help individuals begin to focus on their physical health (Umberson and Montez, 2010). An Age UK (2018) campaign involved a study on providing tailored social interventions to people who were low in mood and felt lonely; 88% of people surveyed felt less lonely after the intervention.
It is clear that a focus on social prescribing and utilisation of community services working together supports and prevents loneliness, social isolation and frailty. Working as a Complex Care Nurse Sister in a PCN, I can confirm we provide holistic person-focused care. We work closely with GPs, social prescribers and wider multidisciplinary teams to signpost to relevant early intervention services. This means that, together as a PCN, we are able to prevent crisis moments occurring and help people to live well for longer.