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An Introduction to The Cost of Living Crisis - A Primary Care Network Perspective

Updated: Dec 6, 2022

As always, we write our content for new Primary Care Network leaders to help them gain a better understanding of the context they are working in.

With a spotlight on the cost of living in the news, this is a good opportunity to write an introduction to the cost-of-living crisis from a Primary Care Network perspective.

In this blog, we break down the following:

  1. What is the cost of living crisis?

  2. How the rising costs of energy, food, fuel and goods can affect our health

  3. The impact on general practices

  4. The impact on Primary Care Networks

  5. The impact on employees

We also provide;

  • Three examples of how Primary Care Networks provide initiatives to support their community.

  • Links to further information containing a report and a webinar on health coaches

  • Links to our blogs covering personalised care and health inequalities

  • A link to the Citizens Advice cost of living data dashboard. Let's jump in!




The ‘cost of living crisis’ refers to the fall in ‘real’ disposable incomes (that is, adjusted for inflation and after taxes and benefits) that the UK has experienced since late 2021. It is being caused predominantly by high inflation outstripping wage and benefit increases and has been further exacerbated by recent tax increases”.



Whilst much focus is on the rising cost of energy, food, fuel and goods and the risk of more people falling into debt, the increasing costs of living have a significant impact on the health and wellbeing of our communities, especially in areas which are already experiencing health inequalities.

Did you know?

  • Children growing up in cold, damp homes are more than twice as likely to suffer from respiratory conditions than their classmates in warm homes (Health Foundation)

  • £1.1 billion is the estimated annual cost to the NHS of asthma care (Asthma and Lung UK)

  • £1.3 billion is the amount the NHS in England spends each year treating preventable conditions caused by cold, damp homes (National Energy Action)

  • £590 – £1,450 are the additional energy costs incurred by dialysis equipment (Kidney Care UK)

  • Rising food insecurity is increasing the prevalence of physical and mental health conditions caused by hunger and unhealthy diets.

  • Food insecurity is linked with malnutrition, obesity, eating disorders and depression, and obesity is now overtaking smoking as the number one cause of preventable death in England and Scotland.

The impact on general practices

  • Increased wages are driving up recruitment competition. In some areas, this is putting additional strain on practices to compete with the NHS pay rates, on top of the already wage disparities between general practice and PCN staff hired using the additional role reimbursement scheme.

  • GP partners will likely face a pay cut this year because of inflation and recommended pay rises for practice staff which are greater than the uplift to practice funding.

  • Energy increases will also be an additional cost to contend with.


Impact on Primary Care Networks

Many networks that commission roles from agencies will no doubt be receiving increased invoices to reflect the increasing costs of living and working.

This will impact the affordability of some roles for the network, and the increased cost may push roles outside of the reimbursable scheme maximum threshold.

In our introduction to Winter Pressures blogs, we shared that Winter Pressures is an NHS term that defines the spike in demand when an already stressed system experiences increased pressure, impacting patient wait times and staff absences.

This increasing pressure on top of the cost of living concerns may see practices focus solely on core general practice demands, making it challenging for PCN staff to engage them in PCN work. At the other end of the spectrum, PCN staff may be pulled into support practices.

Both scenarios are understandable and can be difficult to navigate.

There are a lot of competing priorities and simply not enough time, people and energy to continually sustain the current pace of work.

This is where PCN leadership teams need to work with their practices to help give them the support they need.

Impact on employees

Regardless of your income, we will all be impacted by the increasing cost of living crisis.

In the UK, NHS Employers reported that one in eight workers are already unable to meet their essential living costs, and they predict this number will increase.

A poll of NHS trusts by NHS Providers has found that every trust surveyed reported concerns about the mental, physical and financial wellbeing of staff due to the cost of living. The report also highlighted that nurses are skipping meals to feed and clothe their children, and staff are finding it hard to make the journey to work because of rising living costs.

How can Primary Care Networks provide initiatives to support their community?

Social Prescribing

Research shows that people living in more socially deprived areas suffer more than less socially deprived areas. External factors such as the pandemic and the cost of living crisis are causing more people to suffer and, as a result, a decline in their mental health.  

Social prescribing is a means of enabling GPs, nurses and other health and care professionals to refer people to a range of local, non-clinical services. In Deal and Sandwich PCN, their social prescribing team supports

  • Housing-related queries

  • Welfare benefits & debt advice

  • Help with daily living tasks

  • Making lifestyle changes

  • Combating isolation/loneliness

  • Living with anxiety/depression

  • Bereavement

  • Frequent attendance GP or A&E

Through targeted work with specific groups identified through proactive approaches.

Health and Wellbeing Coaching

Along with social prescribing, health and well-being coaching can help to identify and address unmet social needs and health inequalities through targeted work with specific groups identified through proactive approaches.

New research by Professor Richard Griffin, Professor of Healthcare Management, shows how Health and Wellbeing Coaches (HWbCs) are inspiring lifestyle changes in patients in northeast London.

What does a health and Wellbeing Coach do?

The Shoreditch Trust (2022) describe the role as working “alongside people who need additional support”.

These may be people:

  • With or at risk of a long-term condition

  • Struggling to adapt their lifestyle

  • Concerned about a recent health test result

  • Managing chronic pain

  • Who is living with depression and anxiety

  • Who may need support managing their weight


In a recent webinar we hosted in partnership with NHS England, we also explored the role of the Health and Wellbeing Coach. Please click to review the webinar.


A Health and Wellbeing Coach considers the whole person in addressing existing issues and encourages the proactive prevention of new illnesses, promoting lifestyle medicine approaches.


Health coaching revolves around using coaching skills to support people with lower levels of patient activation to develop the knowledge, skills and confidence to manage their health and wellbeing whilst increasing their ability to access and utilise community support offers.


To provide a balanced view and based on my experience of leading and managing multiple Primary Care Networks, it's common to find varying degrees of engagement when it comes to social prescribing and health coaching with practices not always seeing the value in these interventions. If you’re doubtful of the impact social prescribing and health coaching can bring, check out @SekeramMohan, aka Dr Mohan Sekeram, on Twitter.


Through our podcast, The Business of Healthcare, I have had the opportunity to speak with Dr Mohan Sekeram, who is;

  • The South West London clinical lead in Personalised Care

  • The Clinical Lead for Social Prescribing in Merton and Wandsworth Borough

  • The locality lead East Merton Borough

  • A GP Partner at Wide Way Medical Centre

  • A London Deanery GP Trainer and Mohan also sits on Merton LMC

Mohan is a tremendous advocate for Personalised Care and Social Prescribing. He has amassed over 35,000 followers across Tik Tok, Twitter, Instagram and LinkedIn, where he shares fun and accessible information on Social Prescribing, Health and Wellbeing and Personalised Care. Sharing information


Mid Dorset PCN is using their website to share information and advice. https://mid-dorsetpcn.co.uk/cost-of-living-help-and-advice/

Facebook and other social media sites are also great ways to share information and signpost.

I would also extend sharing information of support with your peers and colleagues.

Want to find out more about how the cost of living is affecting your area?

Citizens Advice is seeing an increase in people asking for help with crisis support, energy problems and not having enough money to make for basic day-to-day living.

The Citizens Advice cost of living data dashboard, which at the time of writing this blog, is updated regularly, shares insights from across their service on how the crisis is affecting the people they help.

I have taken a couple of screenshots but please click the link for full access: https://public.flourish.studio/story/1634399/





We hope this helps!


 

About the Author


I'm Tara; I am the founder of THC Primary Care, an award-winning healthcare consultancy specialising in Primary Care Network Management and the host of the Business of Healthcare Podcast, where we have now published over 200 episodes.


I have over 20 years of project management and business development experience across the private and public sectors, and I have supported over 50 PCNs by providing interim management, training and consultancy.


I have managed teams across multiple sites and countries; I have an MBA in Leadership and Management in Healthcare, I'm published in the London Journal of Primary Care, and I am the author of over 250 blogs.


I have three children. My eldest has Asthma, my middle child has a kidney condition called Nephrotic Syndrome, and my youngest daughter has Type 1 Diabetes, so outside of work, healthcare plays a massive role in my life.


 






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