Project
WellFamily
Funding
£300,000 a year from Hackney Council's public health budget for five WellFamily co-ordinators across 30 GP practices
Background
Doctors often see disadvantaged and isolated parents and families who need practical, social and emotional support as opposed to medical services. In 1996, a GP practice in Hackney, north east London, gained Department of Health funding to employ a family support co-ordinator and the WellFamily scheme was born.
Action
The project, which is run by the charity Family Action, provides a "single door" at GP surgeries for wide-ranging family support including counselling, advice and practical help.
GPs refer patients with complex problems to one of five WellFamily co-ordinators, who are mainly psychotherapists or counsellors.
The co-ordinators hold weekly sessions at 29 GP practices in Hackney and one in the City, providing advice and information on issues such as housing, family finances, employment and parenting. They also provide counselling for emotional problems including anxiety, depression, bereavement and relationship issues, putting people in touch with specialist services where necessary.
"Many are referred for being 'depressed' and we then discover lots of things are going on, like domestic violence," says service manager Emel Hakki. "Most people are facing multiple issues. We may see one individual, but we're thinking of the whole family."
The support is generally spread over six to eight 45-minute sessions. The first is a full assessment, which includes any child protection concerns. The co-ordinator then draws up an action plan, setting realistic goals and ways to achieve them.
If a child needs emotional support, he or she may be referred to First Steps, an early intervention community psychology service. Or the whole family may be referred to the Child and Family Consultation Service, run by City and Hackney Child and Adolescent Mental Health Service. "Some have never spoken to anybody about their emotions before," says WellFamily co-ordinator Beverley James.
The co-ordinators have access to the GP database, enabling them to record notes directly onto the system, so information is shared with doctors and the impact of their service can be tracked.
Outcome
An independent evaluation of the service by Dr Alison Longwill, director of mental health at Improving Health and Wellbeing UK, shows that 81 per cent of 92 service users found the service had mostly or definitely helped them achieve their goals. Meanwhile, 95 per cent of 27 GPs described WellFamily as very or extremely useful. Nine out of 10 said the service had reduced repeat or inappropriate visits, with one patient sample showing a 70 per cent reduction.
A sample of 387 service users showed a decrease in the severity of general anxiety disorder and depression.
A social return on investment analysis suggest a return of £5.96 for every £1 spent on the service.
