EDITORIAL BOARD Irene Anderson, Principal Lecturer and Reader in Learning and Teaching in Healthcare Practice, University of Hertfordshire Russell Ashmore, Senior Lecturer in Mental Health Nursing, Sheffield Hallam University Steve Ashurst, Critical Care Nurse Lecturer, Maelor Hospital, Wrexham Christopher Barber, Freelance Lecturer and Writer Dimitri Beeckman, Professor of Skin Integrity and Clinical Nursing, Ghent University, Belgium Jacqueline Boulton, Lecturer in Adult Nursing, Faculty Lead for student mobility, electives and global health, Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King’s College London Beverley Brathwaite, visiting senior lecturer, Middlesex University Nicholas Castle, Head of Professions/ Assistant Executive Director, Hamad Medical Corporation Ambulance Service, Qatar Jothi Clara J Michael, Director of Nursing, IHH Healthcare, India Emma Collins, Nurse Consultant, Sexual Health In Plymouth, University Hospitals Plymouth NHS Trust Alison Coull, Lecturer at Queen Margaret University, Edinburgh Angela Grainger, Senior Lecturer, BPP University Michelle Grainger, Ward Manager, Moseley Hall Hospital, Birmingham Barry Hill, Director of Nursing, Midwifery and Health Employability, Northumbria University, Newcastle upon Tyne Helen Holder, Senior Lecturer, Nursing Studies, Birmingham City University Mina Karamshi, Specialist Sister in Radiology, Royal Free Hospital, Hampstead Jacqueline Leigh, Professor and Director, Nursing and Midwifery Education, Edge Hill University Joanne McPeake, Acute Specialist Nurse/ Senior Staff Nurse in Critical Care; Honorary Lecturer/Practitioner in Critical Care, University of Glasgow John McKinnon, Senior Lecturer, School of Health and Social Care, University of Lincoln Michelle Mello, Deputy Director: Workforce Development / National Clinical Lead, Personalised Care Group, NHS England/ NHS Improvement Aby Mitchell, Senior Lecturer Adult Nursing, University of West London Joy Notter, Professor, Birmingham City University & Saxion University of Applied Science, Netherlands Hilary Paniagua, Principal Lecturer/Head of Doctoral Studies Faculty of Health & Well Being at the University of Wolverhampton Ian Peate, Director of Studies, Head of School, Gibraltar Health Authority Kendra Schneller, Nurse Practitioner, Health Inclusion Team – Vulnerable Adults and Prevention Services, Guy’s & St Thomas’ NHS Foundation Trust John Tingle, Lecturer in Law, Birmingham Law School, University of Birmingham Geoffrey Walker, Matron for Medicine, Cardiology and Specialist Nursing Services Poole Hospital NHS Foundation Trust Jamie Waterall, Deputy Chief Public Health Nurse, Office for Health Improvement & Disparities; Honorary Professor, University of Nottingham Jo Wilson, Director, Wilson Healthcare Services, Newcastle Cate Wood, Research Fellow, Oxford Brookes University.
Preventing loneliness linked to frailty in the community
Jennifer Crozier, Complex Care Nurse Sister, Stalybridge Dukinfield and Mossley Primary Care Network
Loneliness and social isolation increase the risk of developing frailty; 10% of people over 65 years have a degree of frailty (Davies et al, 2021). People living with a degree of frailty are at higher risk of health problems, such as cardiovascular disease, lung disease, obesity, fractures and depression (Turner, 2014). In people aged over 65 years, hip fractures alone cost the NHS over £2.3 billion a year (NHS England/NHS Improvement, 2022). The NHS Long Term Plan (NHS England/NHS Improvement, 2019a) highlighted that personalised care can promote and support wellbeing and overall health outcomes.The plan emphasises the importance of a person-centred holistic approach, focusing on physical and mental health issues, while supporting people socially.
Social prescribing involves signposting people to a variety of local area-based services that can support them to become integrated into their community. It is made up of many different community and voluntary organisations that provide a wide range of services to match each individual’s interests, such as gardening projects, information on becoming a volunteer, befriending services and education services (Buck and Ewbank, 2017). Some argue that there is not enough evidence on the effectiveness of social prescribing (Husk et al, 2019). However, NHS England/NHS Improvement (2019b) disputes this and has set out six key principles as a guide for a comprehensive personalised care model and believes working with trained social prescribing link workers is imperative.The six key principles are shared decision making, enabling choice, personalised care and support planning, supporting self-management, having access to personal health budgets and, finally, social prescribing and community-based support.
How can loneliness and frailty deterioration be prevented? The NHS Long Term Plan identifies a key component to achieving this is the implementation of primary care networks (PCNs) (NHS England/ NHS Improvement, 2019a). PCNs are networks of health professionals working with groups of GP practices to provide integrated personalised care to the local population. PCNs can support people with more complex needs, they provide anticipatory, proactive care and have the ability to offer a range of interventions.They give people improved access to services and support them physically, mentally and socially. PCNs signpost and refer people to relevant services, offer face-toface assessments, using shared decision making to determine individual’s needs.
Studies show that social interactions lift mood and alleviate depressive and anxiety symptoms (Min et al, 2016). Focusing on social and mental health concerns can help individuals begin to focus on their physical health (Umberson and Montez, 2010). An Age UK (2018) campaign involved a study on providing tailored social interventions to people who were low in mood and felt lonely; 88% of people surveyed felt less lonely after the intervention.
It is clear that a focus on social prescribing and utilisation of community services working together supports and prevents loneliness, social isolation and frailty. Working as a Complex Care Nurse Sister in a PCN, I can confirm we provide holistic personfocused care.We work closely with GPs, social prescribers and wider multidisciplinary teams to signpost to relevant early intervention services.This means that, together as a PCN, we are able to prevent crisis moments occurring and help people to live well for longer. BJN
Age UK. Loneliness research and resources. 2022. https://tinyurl.
com/2p8a3a4c (accessed 30 March 2022) Buck D, Ewbank L;The King’s Fund.What is social prescribing? 2017.
https://tinyurl.com/2p93pkdx (accessed 30 March 2022) Davies K, Maharani A, Chandola T,Todd C, Pendleton N.The longitudinal relationship between loneliness, social isolation, and frailty in older adults in England: a prospective analysis.The Lancet Healthy Longevity. 2021:2(2):E70-E77. https://doi.org/10.1016/ S2666-7568(20)30038-6 Husk K, Elston J, Gradinger F, Callaghan L,Asthana S. Social prescribing: where is the evidence? Br J Gen Pract. 2019;69(678):6-7. https://doi.org/10.3399/bjgp19X700325 Min J,Ailshire J, Crimmins EM. Social engagement and depressive symptoms: do baseline depression status and type of social activities make a difference? Age Ageing. 2016;45(6):838-843. https://doi. org/10.1093/ageing/afw125 NHS England/NHS Improvement.The NHS long term plan. 2019a.
https://bit.ly/3IYiCdq accessed 30 March 2022) NHS England/NHS Improvement. Shared decision making: summary guide. 2019b. https://bit.ly/3DrsgUK (accessed 30 March 2022) NHS England/NHS Improvement. Frailty resources. 2022. https://bit.
ly/3iJH0Vr (accessed 30 March 2022) Turner G; British Geriatrics Society. Introduction to frailty. 2014.
https://tinyurl.com/4729spy4 (accessed 30 March 2022) Umberson D, Montez JK. Social relationships and health: a flashpoint for health policy. J Health Soc Behav. 2010;51(Suppl):S54-66. https://doi.org/10.1177/0022146510383501
British Journal of Nursing, 2022, Vol 31, No 7