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Revolutionary plan to save the nation’s health

‘Reverse innovation’, which could help us to reconnect with our GP, could not have come at a more propitious time

05 November, 2020 — By John Gulliver

Dr Matthew Harris was inspired by a ‘community link’ scheme while working as the equivalent of a GP in Brazil several years ago

WHY is it so often difficult for many people to make contact with their GP – even now as the nation totters into a massive lockdown? Who can help the vulnerable elderly person living alone with a serious illness?

If the Covid disease is here for months – if not years – to come, can we ever even contain it?

What can be done to revolutionise the failed track-and-trace system the government has squandered £12billion on trying to make it work?

The answers may be found in a project that a leading scientist has been working on for several years whose time, perhaps, has come at last.

It is set out in the current edition of the prestigious Journal of the Royal Society of Medicine in a paper whose principal authors include Matthew Harris, public health consultant at Imperial College – and the man who has been promoting the idea over the years – and Cornelia Junghans, a fellow practitioner attached to Westminster Council’s public health department.

And this week the department is considering it – even, prepared, I hear, to introduce a pilot scheme that, if successful, could revolutionise the way medicine is practiced in Britain.

The authors of the scheme have done so much research into it they have calculated it could be introduced nationally – employing 110,000 people and costing around £2billion, a fraction of the money the government has wasted on failed attempts to suppress the Covid pandemic.

And it all began to take shape in the mind of Matthew Harris while working as the equivalent of a GP in Brazil several years ago.

Impressed by the way their primary medical system works he thought: why can’t we try it in Britain?

Under the Brazilian system – similar to primary care work in Cuba – every household in the city where Dr Harris worked would be visited by a “community link” worker who would check on any problems residents were having – if they needed any form of medical or social help, for instance.

All too often people do not know who to turn to for help, or how to make what is often a simple medical enquiry.

The “link worker” doesn’t have to be medically trained – anyone with a confident manner and a curious mind could do the job.

If adopted in Britain – regarded in medical circles as “reverse innovation”, that is the use of an idea spawned in a less developed or poorer country and introduced to an advanced nation – it could not have come at a more propitious time.

Earmarked for the revolutionary pilot scheme is a small zone in Churchill Gardens in Victoria, covering about 1,000 households.

It is reckoned that each community link worker would have about 250 houses on his or her beat. Provisionally, the pilot scheme would employ four to six workers. If it is successful, it could then be rolled out, perhaps, into other parts of Westminster.

The project has yet to be approved by the council’s public health committee but it has attracted so much support among public health clinicians, set out in outline in various medical papers and journals, that it is likely to be experimented with.

If successful it would place Westminster at the forefront nationally in public health administration. It is something, I would have thought, Camden public health should take a look at.

NHS England took a step in this direction last year through the existing network of GP surgeries basically using link workers to give long-term patients welfare advice and arrange exercise classes.

The pilot scheme in Westminster of course would go much further – helping to manage chronically ill patients, for instance, with whom they are in regular contact by visiting homes in their patch.

Such a scheme is urgently needed to “improve population health” concludes the article in the JRSM publication.

Certainly it is likely to do that – as well as provide employment in an economy that is collapsing.


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