2. Commercial expertise driving value and efficiency in local public services General Practice improvements to social quality of life Dr James Fleming

3. Solutions to unemployment and isolation when no other agency can help Aim

4. A Story Patients who others could not help - isolated, long unemployed, furthest from labour market, agoraphobic, clinically dependant, excluded, low self-esteem I treated the medical problems, but this was making them ill. Was there a role for me to do more? Further learning and information gathering Finance 1.Individual tailored care 2.Marry health/social needs 3.Community Development 3

5. Case example  30 F ‘Am I depressed?’ Wants sick/fit note  Tearful, rock bottom, drinking  Rent arrears, debt, poor housing  Little self-esteem, not worked for years  Stuck where she is, can not see a future  Repeated attendances at GP, little progress 4

6. Present care  Do nothing, give differing advice, ‘not my job’  Anti-depressants, anti-anxiolytics  Tell to go to JC+ – sick note?  Present self to alcohol services  Citizen’s advice  Contact health visitor for support  Counselling  Personal reckoning – hope for the best 5

7. Why this is not working - evidenced Unable to navigate services alone Worries about not getting money Requires deep understanding of self Requires confidence Peer pressure Unable, unwilling to travel No reference Can’t manage the transition, no-one has time

8. Green dreams approach in detail o Send from GP, motivate, believe o Identify barriers to increased QOL o Contact JC+ for financial stability, go with her o Liaise c landlord, HMRC, DWP, Welfare Rights o Involve in one of our projects, build confidence o 3 rd sector, Stubbylee, CVS, mapping, overlap o Complete documents, correspondence, CV o Access Training and coordinate o Lifestyle and health issues 7

9. Social Isolation Bingo, venue, machinery, self funding now Day trips – self funding (Hawes, Skipton) Meet old friends, laughter, dress-up Now, never comes to doctor Also, home visit, befriending, fitness, craft, voluntary organisations, walks, computer, procure space, Art Group, Theatre Group, Knit and Knatter

10. Green Dreams Bingo, Padiham, Burnley

12. Video?