James S Thambyrajah: Prescribing compassion at Christmas

The festive season offers a chance to remember that caring for our patients shouldn’t be confined to our practice walls, says James S Thambyrajah

Christmas is often thought of as the most magical time of the year. For many it is a time for faith, family, friends, music, and indulgence, but for some people their Christmas is absent of these blessings. As a GP, I have been reflecting on how we can reach out to our patients on a local level during what should be a time for making human connections.

The Royal College of General Practitioners’ motto is “Cum Scientia Caritas,” which means “scientific knowledge applied with compassion.” I have been inspired (and moved) by general practices that live out this principle by tending to the holistic needs of patients during the festive season. 

When I joined my current practice, I was pleasantly surprised to hear that there has been an annual carol service organised by the practice for years. When I attended the service last year it was a wonderful opportunity to see my colleagues and patients outside the context of the practice environment, bonding and laughing over singing carols. As a GP, it was eye opening to see a patient as my neighbour in our community, rather than as “Mrs X who needs a medication review.”

Another GP colleague of mine helps organise a community hospital Christmas party for people aged over 85 in their area. Local school children sing carols, local businesses donate presents, and people who might feel isolated experience the benefits of company and community.

Of course, people don’t just need help at Christmas, and some practices offer their services as a touchpoint in the community throughout the year. I am inspired by practices who go into the community to help out people who are struggling or less fortunate: Salford Foodbank, for example, has a successful partnership with neighbouring medical practices. As a GP I cannot think of anything more important than looking out for our most vulnerable patients.   

It’s worth remembering that for those of our patients who are lonely at Christmas, this is not just a passing seasonal melancholy, but part of a growing public health epidemic. Loneliness and social isolation are now considered to be just as serious as a chronic health problem in terms of the impact they have on health. It is estimated that 9 million people in the UK are always or often lonely and most GPs say they see between one to five patients every day for this reason. As GPs we see 85% of the population within a given year. This unparalleled access means that we have a key role in identifying people who are either chronically lonely or at risk of becoming lonely.

Thankfully, the government has recognised this with their new strategy on loneliness, which aims to empower GPs across the country to refer lonely patients to various community activities such as cookery classes, walking clubs, and art groups by 2023. 

By highlighting the crucial role of social prescribing, the government’s strategy mirrors the General Practice Forward View’s emphasis on the importance of voluntary sector organisations in reducing pressure on GP services (specifically through social prescribing). Cynics may say that social prescribing is nothing new and that “good” GPs have been doing this for years. This is partly true, but as brilliantly highlighted by our RCGP chair Helen Stokes-Lampard, social prescribing can now be delivered on a much bigger and broader scale.

As I see it, social prescribing enables GPs to put compassion for their patients into practice. Ideally, active social prescribing springs from having a deeper understanding of our patient’s troubles, pain, or distress. Throughout our GP training we are taught to holistically care for our patienttending to the whole person by addressing their psychological, spiritual, and social needs (along with their obvious physical needs). If we embrace this approach then social prescribing is a natural byproduct. And with practice, patience, and perseverance, we can build bridges between practices and the corresponding community organisations to deliver the best care for our patients.

So as we head towards another busy winter, I implore those reading this to reach out towards their loneliest and most vulnerable patientswhether it’s via an impromptu home visit, organising a meal, or helping patients through social prescribing. I would argue that it is our duty to care for these patients not just within the confines of our practice walls, but within our local community too. Let’s strive to make their Christmas a more memorable one, but not forget to think about how we can make their lives happier and healthier all year round. Perhaps your personal development plan/new year’s resolution can include prescribing more compassion to your patients.

James S Thambyrajah is a general practitioner and first 5 lead GP for RCGP SW Thames Faculty. Twitter @JThambyrajah 

Competing interests: None declared.