Additional roles in Primary care are emerging.  These roles along with Social Prescribers and Primary Care Receptionists  are integral to the success of Integrated Person- Centred Care and in supporting Multi-Disciplinary Teams (MDT) especially in areas of deprivation. They advocate on behalf of people who receive care and their families/carers by working to bridge the gap between health and social care. Note Green social prescribing i.e. access to nature has been shown to  improve mood, health, and wellbeing. It is better for the environment and is financially very sustainable for health systems.

Learning the HANDY APPROACH TO CARE can be done in less than 5 minutes (click here for short film on YouTube) by going through the following steps:
• Draw an outline of your hand on an A4 piece of paper.
• Number your fingers from 1 to 5 starting with the thumb.
• Circle the thumb and index finger and in this circle write the word ‘Mental’, circle the middle finger and write the word ‘Physical’, circle the ring finger and write the word ‘Social’ and circle the little finger and write the word ‘Personal’.

Then as if you were a tattoo artist tattoo the word:
‘cognition’ on the thumb
‘consent’ on the index finger
‘function’ on the middle finger
‘setting’ on the ring finger
‘hopes’ on the little finger

Now think about a person you visited recently and call the person B… Then ask yourself the following five questions in this order mapping on your hand as you ask, starting with the thumb:
• Is B… able to remember what they did yesterday?
• Does B…. give us permission to be involved in their care?
• Is B… able to get out of bed?
• Is B… alone at night?
• What matters to B… on a good day?

Jean’s story
Jean had a history of very low mood, she often did not verbally engage with health or social care professionals when they visited, she was taking multiple medications especially for her pain, she would phone her GP and the Ambulance Service frequently and was very often critical of her carers; Jean was able to remember what she did yesterday and give permission for us to be involved in her care; she had been bed-confined for several years; she was alone at night and what mattered to her was to go to her daughter’s wedding in Portugal.
Jean knew that it was physically impossible for her to attend her daughter’s wedding and the Multi-disciplinary Team were unsure how to support her. Someone in the team asked what she did on a good day for her and we knew that she enjoyed watching TV but she needed her glasses checked and her ears syringed urgently. Someone else asked if she had technology on her TV that would enable her to see and talk to her daughter. We established that she was not aware of this technology and that she was keen to try it out. She gave us permission to contact the social networker/prescriber to see if a voluntary sector organisation could help install the technology and they installed the necessary software.
On the day of her daughter’s wedding, her carers helped her to dress up and she was able via social media, to give her daughter her blessing. Her mood started to improve, she complained less about her pain and her need to contact her GP frequently stopped. She became more kind to her carers who in turn became more kind to her.

Getting advice when using the handy approach to care is in the following situations

1. If the person cannot remember what they did yesterday even with prompting
2. If the person is confined to their bed i.e. unable to get out of bed at all
3. If the person is alone at night

Lastly, think about your interactions in your personal relationships.
This is to help you engage in empathetic, healing conversations asking ‘What is strong with you?’ rather than ‘What is wrong with you?’ This is achieved through   strength-based approaches and  a recognition of how adversity contributes to longterm  illness.

Bring to mind someone you know well and give this person a name S…
Then think about what you noticed about S… when S… was having a good day and then think about what you noticed about yourself. This is to draw attention to the positive cycle of interactions from noticing when people around us feel happy and how that impacts on our mood and motivation.