Proactive Care Team

Working together through a single point of access, the Proactive Care Team aims to reduce and support the workload of GP's and other staff by identifying and supporting patients to take more control of their health and wellbeing, and by providing coordination and navigaton of care across primary, secondary and voluntary health care services.

The Proactive Care Team supports the practice to identify patients most in need of proactive support, for example, people living with frailty or people with multiple long-term physical and mental health conditions, whilst also addressing wider detriments of health such as loneliness or poor housing. We work individually with patients, building trusting relationships, listening closely to what matters to you, and working together with you to agree a support plan.

Social Prescribing 

Our team of Social Prescibers are here to help you look after your health and feel better. Lots of things in your everyday life can affect your health and get in the way of making the changes you want to make. Instead of giving you a prescription for a medicine, your Social Prescriber will work with you to create your own social prescription. This will help you to access activities and support that will improve your health and enjoyment of life. Whatever worries or questions you may have, we are here to listen and will help you get the advice and support you need. 

Health and Wellbeing Coach

Our Health and Wellbeing Coach is here to help and support you in taking proactive steps to improve the way you manage your physical and mental health conditions, based on what matters to you.

This is done via shared decision making, personalised care and support plans. Helping you find health services and supporting you to develop knowledge, skills and confidence to manage your own health and wellbeing.
The Health and Wellbeing Coach works alongside those who have long conditions like type 2 diabetes or chronic obstructive pulmonary disease (COPD). Those that are at risk of developing long-term conditions and providing support for issues such as weight management, managing chronic pain or living with depression or anxiety.

Care Coordinator

Our Care Coordinators provide extra time, capacity, and expertise to support patients in preparing for clinical conversations or in following up discussions with primary care proffessionals. They work closely with the GP's and other primary care colleagues (Social Prescriber and Health and Wellbeing Coach) with the primary care network (PCN) to identify and manage a caseoad of identified patients, making sure that appropriate support is made available to them and their carers (if appropriate), and ensuring that their changing needs are addressed. They focus on the delivery of personalised care to reflect local PCN priorities, health inequalities or at risk groups of patients. They can also support PCNs in the delivery pf Enhanced Health in Care Homes.

What support can I get?

Our Proactive Care Team can help support you with a range of issues, including:

  • Long term health conditions
  • Social isolation
  • Emotional wellbeing
  • Healthy lifestyle choices inc diet and nutrition
  • Getting out and about
  • Life changing events such as birth, retirement, bereavement
  • Loss of confidence/purpose
  • Poor health linked to housing or housing conditions
  • Accessing work, training and volunteering

What are the benefits?

  • Improve your mental and physical health
  • Learn a new skill or participate in a new activity
  • Increase your self-confidence and self esteem
  • Get involved in your community

How to book an appointment?

You can book an appointment by speaking to a member of our reception team and requesting a session with our Social Prescribers or Health and Wellbeing Coach. Your GP, or other members of the practice team, may also refer you to the service if they feel it would be helpful.

Does it cost anything?

 No, our service is free.