Lifestyle Medicine Service, North Lewisham PCN – Lifestyle Medicine in Practice

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Dr. Camille Hirons is a salaried GP in North Lewisham, the lead for Health inequalities in her PCN and a certified Lifestyle medicine physician. After studying the IBLM she was on a mission to bring lifestyle medicine to the NHS and more specifically the local population of North Lewisham. She was granted a two year SPIN fellowship to allow her the time to create a local NHS lifestyle medicine service.

North Lewisham PCN is made of 9 GP surgeries and has a population size of over 85,000 patients. The local community in North Lewisham is vibrant and diverse but also has some of the highest levels of deprivation, being the 7th most deprived in London and one of the most deprived PCNs in the borough. There are avoidable and unjustified differences in health outcomes amongst the population with higher levels of co-morbidity in more deprived areas. North Lewisham has proudly conducted 2 years of community engagement work and endeavours to co-design new health services based on the needs and wants of the local population, and taking the wider determinants of health into account. With this in mind the Lifestyle medicine service was co-designed during 6 workshops with local residents, community based organisations and stakeholders. Issues and concerns such as the barriers to patient engagement, issues with existing service, patient access and reaching underserved communities were broken down and addressed collaboratively.

The Lifestyle medicine service was co-designed as follows:

Objectives:

1. Prevent and reduce illness (focus on CVD): striving for optimal health.
2. Sustainably increase and develop ‘wellness’.
3. Supporting people to increase agency / control over health
4. Improve access to care, especially for underserved communities.

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• Delivered at PCN level, working in a wellness hub model (all ARRS roles, such as social prescribers, inclusion health care coordinator, mental health practitioner and so on, work closely together to allow multidisciplinary working and collaboration).
• Run by health and wellbeing coaches and nutritionists (hired using the ARRS PCN budget).
• Patients offered 6 group coaching consultations – breaking down each pillar of lifestyle medicine AND 6 one-to-one consultations with a coach to work on the individuals goal. A follow up appointment is offered at 3 months.
• Appointments can either be virtual or face-to-face, interpreters are used when needed.
• Optional biometric data, qualitative surveys and validated wellbeing questionnaires are taken before and after the service engagement to help with service evaluation.
• ANYONE can either self-refer or be referred into the service however we are actively inviting patient at risk of cardiovascular disease and the under served communities (such as those who do not routine access medical care).
• Exclusion criteria are as follows: under 18, unstable mental health (such as active psychosis or dementia) or not being registered with one of the GP surgeries within the PCN.

The clinic has been operating since April 2023 and with a few more months of service delivery we hope to start service evaluation.

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LM Pillars Covered:	Healthy Eating Mental Wellbeing Healthy Relationships Physical Activity Minimising Harmful Substances Sleep
Funded?	Yes – PCN, SPIN, Novartis
Initiative Sector:	NHS
Approving Body:	Primary Care Network

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