Bridging the gap between healthcare and wellbeing #2

Photo by Jon Tyson on Unsplash

So last week we saw that the UK National Health Service, groping its way to being a Neighbourhood Health Service, is seeing the value of directing people from GP surgeries to community groups. Faith groups–and especially in the UK, Christian churches–are the main source of community groups, and they are everywhere.

In a report about all this, the Theos thinktank notes that some GP practices employ social prescribing link workers (SPLWs, because the world needs more acronyms) to make and maintain these connections. So far so good. But the people at Theos make these observations:

  1. Where there’s a high turnover of SPLWs, many of the links are lost.
  2. When SPLWs merely ‘signpost’ people to things a lot of the potency of social prescribing is lost. (This is true generally with the dread word ‘signposting’. People are often refused help by one agency or another and ‘signposted’ elsewhere. This is fine for the people who are turning people away, but not so good for the people who are being turned away). It’s much better when SPLWs get to know groups personally and also take people along to them. The personal relationships matter much more than a listing of providers.

As the report said:

..We found a number of challenges … There are communication challenges because faith and health communities use different language to talk about very similar things. It is challenging for faith groups to connect and maintain relationships with the ever-changing social prescribing system. Similarly, link workers and local health practicioners don’t kow where to go to connect with local faith groups. Furthermore, there are administrative challenges that slow processes down and a lack of funding to keep activities running. (p15)

Further, ‘one explanation for poor integration between faith groups and healthcare workers … is stretched capacity in the NHS’ (p61).

But social prescribing is a ‘thing’ and the NHS has a long term plan for every person in England to access social prescribing through their GP eventually. 1

3. While there are relatively many hospital chaplains, there are relatively few ‘GP chaplains’ and this is a missed opportunity. N0t only so, but a qualification in social prescribing takes about 5 months’ study 2. No doubt lots of people have thought of this, but a GP chaplain who was also a trained social prescriber could make themselves very useful; if they were funded by a collaboration of churches, they would be less dependent on the vicissitudes of government provision.

Bridging the gap between healthcare and wellbeing

Sometimes you read something and it feels like you’ve swallowed a lit firework.

This happened to me recently, when I was reading a report from those good people at the Theos thinktank. I found myself catching myself to hold back the tears.

This is the report:https://www.theosthinktank.co.uk/research/2025/01/27/creating-a-neighbourhood-health-service-the-role-of-churches-and-faith-groups-in-social-prescribing

And I recommend you waste half an hour of your working day to read it. It’ll be time much better spent than doomscrolling.

The idea is simple and one that I’ve touched on before in this blog. Here I found myself lifting the curtain and seeing a whole landscape of people who have not just already thought of this but are integrating into their practice, and researching the problems, and finding ways forward, actual doers doing it. In other words, a bandwaggon, and this is me jumping on.

  1. Health care providers see the need for ‘social prescribing’ (involving people in caring communities) as a necessary supplement to their medical work. Indeed many people visit their doctors because their sickness is actually a mask for other ills, like grief or loneliness.
  2. Churches have been working for the common good for centuries.
  3. Why not put them together?

Here’s what our current Health Secretary, Wes Streeting, said about the report:

Faith groups are continuing a beautiful, centuries–old tradition of caring for your neighbour. They are delivering front line activities that will play a key role in shifting the focus of our health service from hospital to community, and sickness to prevention in the coming years. I welcome this report from Theos, which asks the right questions about how we can link faith groups into the system to provide partnership and support.” – Wes Streeting MP, Secretary of State for Health and Social Care of the United Kingdom

Or or a past president of the Royal College of General Practitioners, Clare Gerada:

I wholeheartedly endorse the invaluable role of faith groups in the social prescribing framework, as outlined in this report. By fostering trusted relationships and providing holistic support, faith communities are uniquely positioned to bridge the gap between healthcare and wellbeing, offering a preventative approach that prioritizes connection, care and community.

From the foreword:

Social prescribing utilises community offerings as non-clinical remedies in recognition that some things can be treated both more effectively and more cheaply this way. The particular genius of this is that in doing so, people know each other better; relationships between statutory and community groups are formed and become well-trodden; and when moments of crisis arrive, not only are communities healthier at local level, but more resilient.

In one sense, none of this is new; in another it is a confluence of trends in medicine, society and church that suddenly opens a vast horizon of opportunity.

  • Health care people know how vital is the social stuff surrounding a person’s health. We have an epidemic of mental ill-health (or possibly an epidemic of mental ill-health diagnoses) and we have another cluster of people with the too-much-stress illnesses caused by their bodies running hot with anxiety.
  • Many people are lonely and isolated, propped up by benefits.
  • Churches are caring for the common good in practically every community.

It seems there is within the NHS a job role called a Social Prescribing Link Worker whose job is to connect patients at GP practices to local community groups. It can be that on a single street, next door even, a GP practice can exist in one silo and a church with its community cafe or craft group in another silo. The SPLW’s role, paid for by the taxpayer, is to link people across silos.

Imagine if this were common: every GP practice, every faith community, personally linked together and held together by a network of relationships. Imagine the creativity, the imagination, the good and the healing that could flow.

Finally, though this is a branching-out for the NHS, they are branching out into something churches are already doing. My own little church has basically missed every trend that has passed through the Christian community in the past 40 years, with the possible exceptions of minor brushes with charismatic Christianity, the Alpha course, and worship songs that were contemporary twenty years ago.

But we haven’t missed community groups for the common good because it’s what we do: a community cafe, food supplies, separate men’s and women’s breakfasts, a carpet-bowling club, a craft cafe. We do this all the time for the common good and also because, further in, people may find the glowing Rock at our centre and a framework, indeed a Person, around whom to construct a good life and a good death. They may find worship. They may find they can step back from the daily routine and glimpse eternity. We’ve done these community things, as have so many churches, because that is what we do, because it fits the grain of who we are.

A trellis to grow your life on

A word to the battered and weary.

I keep reading of people who quite tired of figuring out what’s right, what’s wrong, what a good life, what it’s all about. Dating is a minefield. Success is a mirage, celebrity is depressing, freedom is enslaving, hope turns sour, dreams disappoint.

Photo by Jan Canty on Unsplash

Some of these battered and weary people are becoming Christians or if you like, Christian-adjacent, seeing the ancient Christian values as useful signposts even if they are tentative about going the whole hog, or perhaps, the whole dogma.

There’s a lot to this.

For one thing, creaking though it maybe, Christianity is ancient and it has infused our culture and spawned many good lives like nothing else. A couple of hundred yards from our home is a church that was founded in the ninth century. (As I have mentioned before and often think about.) The fields around it had been harvested for hundreds, perhaps thousands of years already by then. But still: for the last one thousand, one hundred years Christian worship, Christian faith and Christian values have been seeping into village and national life and collective memory and ancestry.

For a second thing: Christianity is mainly and mostly about the heart. It isn’t a programme for national prosperity, or preventative health care, or political reorganization. Primarily it pins us like collected butterflies down to one main things: Above all, guard your heart. Blessed are the poor in spirit, the meek, the mourning, the peace-making, the pure in heart, the hungry for justice. And the test of these reformed and reforming hearts is not the mystic poetry they write about the experience (for example), or great revolutionary or counter-revolutionary acts (for another example), but the practical outworking of goodness and faith in their daily lives.

Which can lead to any number of different, interesting, varied, full lives.

No wonder it’s inspired lives across 50 generations, has experienced ups to match its downs, and may yet catch on widely again.

How to transform every community in the West

Nothing too ambitious….

Photo by Jon Tyson on Unsplash
  1. Start with a worshipping community of Christians
  2. It has to use some energy maintaining itself but
  3. It has spare energy to use outside itself so
  4. Do some theology. Christians are heralds of a new world where God and people are together. We can’t make that new world, but we can be a sign of it, an instrument of it. A portent of it, if you like.
  5. Do some Bible study. Around Ash Wednesday (not so far from when I’m writing this) the great passage in Isaiah 58 defines what ‘fasting’ looks like:

“Is not this the kind of fasting I have chosen:
to loose the chains of injustice
    and untie the cords of the yoke,
to set the oppressed free
    and break every yoke?
Is it not to share your food with the hungry
    and to provide the poor wanderer with shelter—
when you see the naked, to clothe them,
    and not to turn away from your own flesh and blood?
Then your light will break forth like the dawn,
    and your healing will quickly appear;
then your righteousness[a] will go before you,
    and the glory of the Lord will be your rear guard.
Then you will call, and the Lord will answer;
    you will cry for help, and he will say: Here am I.

(Isaiah 58:6-9

6. Understand the times. We are not, in the West, surrounded by masses of starving people. But think of all the lonely people.

7. Think of one of the fruits of the covid pandemic. In the UK, local authorities started trusting churches to do community things decently and well. It has always been happening to an extent (it isn’t new) but covid was a kind of crash course for the nation.

8. Think of the need in our day for social prescribing. How many doctor’s surgeries are plagued by the lonely? How many ills (mental ill-health but much else also) can respond to the balm of community? In how many ways can community complement all that the state attempts to provide (housing, cash, healthcare)? Why can’t GP surgeries prescribe community in the same breath as they’d like to prescribe exercise and diet? Why are their options limited to applying chemicals or knives to human bodies?

9 Churches have premises, a certain facility with tea-pots, and a tolerance for the misfitting people whom every congregation anyway hosts.

10. Community heals. Humans are a herding species. Churches have the plant, the location, the resources, the opportunity and — best of all — the moment. We can built the connections. Every community in the West. Think of it.

Community can heal

I was gob-smacked and jaw-dropped, if you can be both, when I watched this this week:

As well as a few side-benefits – a second revolution, saving the NHS, that sort of thing – it was a glimpse into what the future could be like for all of us. And what a happy, healing place it looked like.

At root it what’s being described is, I think, an NHS GP practice in one of the most deprived areas of London, that has realized doctors only get to a fraction of illness. The rest is caused, or cured, by things like employment, education, environment and creativity.

With that realization taken seriously, what has evolved is a thriving community with an NHS medical practice (and, as it happens, a church) at its heart.

I do recommend you put this on next time you are cooking or driving or working out or something. (You don’t need to see the video and the pictures anyway add little to the story.) Instead of a clinical setting, think cafe, community, art, creativity, fun … it’s just really something.

Why not me?

Healing seemed to come quickly in the New Testament

Photo by Johannes Roth on Unsplash

Today (yesterday as you read this), my wife and I listened to the Pray as you go app as we often do, a little daily dose of Ignatian spirituality. The passage was about the person with leprosy who said to Jesus, ‘If you are willing, you can make me clean’ and Jesus’ reply, ‘I am willing! Be clean.’

My body was still upside down after our very recent and lovely holiday in Singapore. We had arrived back three days earlier. I was extremely breathless, perhaps exacerbated by jet lag. The previous evening it had taken me many minutes and several stops to walk the 200 yards in the dark and cold to our post box and I was frightened.

My first thought on hearing the passage was ‘why not me?’

But this was followed by a second thought: ‘It is you, and has been you.’

This lifted my spirits as I realized it was true. It was true in the larger sense 12 years ago when I recovered from a coma in which I was expected to die after my church held a 36-hour prayer vigil. But it was also true in the lesser senses of other bad times and fears negotiated. It was true in the smallest sense of daily acts of grace and goodness to my life and soul. I am a child of the kingdom! What a thing. I am a beneficiary of the power of Christ! Goodness and mercy has pursued me all my life! The (remaining) light and momentary afflictions are not to be compared with the glory to be revealed. In all these things we are more than conquerors through him who loved us.

This time of year we are also putting away the cards and letters received over Christmas, and I see these tendrils of love and faithfulness extending into lives all over the place. So many grateful! So many restored, or maintained, in life and health!

Why not me? It is us. In the midst of the shadows all around, it is us.

Dethroning anxiety

I hope you’ll forgive me for quoting this wonderful blog from Nadia Bolz-Weber. On the face of it, her circle and mine (hers is much bigger) do not much intersect: ordained, tattooed, a former addict, divorced, remarried and probably further over on some theological spectrum than I, but she writes and thinks so beautifully that I would recommend her corner of the internet to you and anybody. Here’s the link that should enable you to sign up. And here’s something she wrote a couple of weeks ago, about anxiety:

As a child I worried a lot about quicksand. To be fair, the TV shows I watched made it seem like more of a potential danger in life than it’s proved to be.

And as a teenager I worried that the Soviet Union would drop nuclear bombs on us but I equally worried that I wouldn’t get tickets to see Depeche Mode.

In my early 20s I was mostly worried I’d run out of booze, and that I would not be able to pay my $325 a month rent. Sadly, I did not think to worry about how those two things might be related.

And when I got sober and I worried that I wouldn’t be funny anymore never realizing I wasn’t all that funny before.

Then I was told to worry that Y2K was going to make airplanes just sort of drop out of the sky.

And when 9-11 happened I for sure worried the terrorist attacks would just keep going and by that time I had 2 babies and that made it feel more acute.

Then when the economic collapse happened in 2008 … honestly I was entirely free from worry because I was entirely free of money. So it was very a relaxing time for me.

Then I worried that people would think less of me when I got divorced not realizing they didn’t think that much of me to begin with.

Feel free to go home and write your own biography of worry. It’s a humbling project to undertake.

But also kind of calming.

Because writing my own this week helped remind me how worrying about what might happen didn’t do one thing to make me feel safe, or to prevent bad things from happening or to ensure that good things did. It really only kept me from being present to the gifts of the day I was in.

… worrying about what might happen didn’t do one thing to make me feel safe … It really only kept me from being present to the gifts of the day I was in

But what I really want to tell you about is how our reading from Revelation helped me this week –

The churches in Asia minor to whom John’s Revelation is addressed had some pretty high anxiety levels too – they were living under the thumb of the Roman empire and the book of Revelation was meant to offer them comfort. It’s famous for 7 headed beasts and heavenly battles and whatnot, but If there is an overwhelming message in this, the weirdest book in the Bible, it would be this: that dominant powers are not ultimate powers. Which is another sermon for another time.

The part of today’s reading that I swear lowered my cortisol levels was this:

In his opening remarks, the writer of Revelation twice refers to God as the one who was, who is, and who is to come. That’s it.

“I am the Alpha and the Omega,” says the Lord God, who is and who was and who is to come, the Almighty.

That is what comforted me this week as I read our texts for today and tried to manage my anxiety while writing a sermon.

That God was and is and is to come.

Or as the hymn goes:

Crown him the Lord of Years,

The Potentate of Time,

creator of the rolling spheres, ineffably sublime.

It helped me this week because it reminded me that this moment we are in is a very small moment in a very big story.  A story of God and God’s people that reaches back to the beginning of time, brushes the skin of the present and moves on into a future we cannot see.  

What I am saying is that I think I am most anxious when I invest myself too fully in some Johnny come lately story.

Because looking again at my autobiography of worry, I think that at each of those anxious points in my life I was believing a story I was being told; in the media and by my friends and from our culture. Which is understandable, but in hindsight most of the stories did not end up being all that true, they just ended up being quickly replaced by new ones so we never noticed.

What I am trying to say is that the beautiful thing about being a people of faith is how we are a very small part of a very big story. We tell it, we sing it, we eat it, we paint it, we read it, because it’s the most true thing we’ve ever heard.  And competing stories will always surround us.  Sometimes, maybe a little bit like our siblings in faith from the churches in Asia minor in the 1st century, we too need reminding that the dominant story is not the ultimate story. That that there is only one potentate of time.

When I look back, in all my times of grief and doubt and sorrow and anger and faithlessness, I can in the rear view, see the mighty hand of God.

To be clear, God was not busily arraigning all my desired outcomes. If that were true, had I gotten everything I wanted I promise you I wouldn’t be alive right now, much less standing here in this pulpit.

But what I can see now, is how often I was saved from having the thing happen that I was so sure would make me happy.

Looking back I see how often I was carried through things I thought I couldn’t survive, and how I was guided to beautiful things I wouldn’t have ever even wished for.

Because God is like a shimmering, divine filament woven into our lives that provides spiritual tensile strength, and beauty in each moment, even when we forget to trust him, even when we forget to pray or be grateful.

Busy doing nothing

Photo by Zach Searcy on Unsplash

A guest post from my friend Colin Bearup, who has spent much of his Christian life serving among Muslim people.

I have noticed that most of us involved in Christian mission tend to hold one of three attitudes to rest. Some of us see rest is necessary for survival. If you don’t rest you can’t keep going, so you just have to stop sometimes. Some of us are more positive; rest is necessary for success. You cannot flourish, prosper, accomplish or triumph if you don’t get a break. And – more rarely – I come across those who see rest as a calling, a delight and a gift from God.

God decreed rest for his people in the Old Testament. One day a week, no work for man, woman or child, whether slave or free. Even the donkeys could put their hooves up. And consider this: there was no internet, no smart phone, no TV, no sport to watch, no books to read, no synagogue to go to. It was a day of quiet. Scary or what? Not working is one thing; doing nothing, that is another. Rest wasn’t just a different way of being busy, which is what I tended to make it.

We all know the Pharisees made it miserable and Christians have been known to do the same, and we are not supposed to live today by the OT law. But God’s intention was and is that we enjoy rest. Call it a delight, said Isaiah (58:13-14). For the ancient people of God, rest was an expression of faith. They could stop because God was in charge and they were relieved of responsibility. Rest for them was an act of worship; intentionally stopping was a way of honouring God. Doing nothing, trusting him and being grateful. Why would we settle for less?

Green old age

Photo by Joseph Corl on Unsplash

Last spring we held a party for three 90-year-olds in our church. In the months since, two have died and the third lost his wife of many years.

It was, perhaps, a good shout that we had the party when we did.

I was thinking about them the other day. I liked them very much. The thing that stood out, I think (particularly in the two who have now passed on) was their zest and enthusiasm for life. They gave life to people, rather than sucking it out of them (as an introvert I am sensitive to this). Bits of them were falling off into the grate, as it were, but the flame was still burning bright. I remember joshing with each of them, weeks, as it turned out, before the end.

A life-filled, green old age can’t be easy, and perhaps doesn’t always happen even with God’s saints. The Bible describes old age as ‘the clouds return after the rain’ (Ecclesiastes 12:2): it must be hard not to be depressed at yet another medical appointment, yet more health-related indignity, yet further limitation. Yet their record stands. This life, this life-givingness, is that what healing looks like in old age and decline?

Following Jesus into the darkness

‘Seeking the one who is higher than us’: photo by Cherry Laithang on Unsplash

When I was a student seminarian, a group of us went camping the high desert in California. I am a timid sort, but a couple of our number wanted to explore some disused gold mines. Miles from anywhere, following the map, we climbed down into one.

At the bottom of the mine was a narrow passage leading to further workings. You needed to crawl through the rubble. No way was I going there, but one of our companions did, crawling into the claustrophobic darkness, and found a further chamber. When he got back, I asked if anyone else had a headache. Everyone did. Mindful of carbon dioxide accumulating in old mine workings, we left.

I do not think too many people in their right minds would follow Jesus into a similar dark hole, dark, closed in, rubble-strewn, deserted and miles from help. We wouldn’t chose it (unless you were my camping companion). And yet sometimes we are taken there.

I was thinking about this during a jet-lagged night recently, and praying for various people I know wh0 themselves had been required by Jesus to follow him into the darkness. They did not have a choice, except perhaps the choice to see Jesus there with them.

Why does Jesus lead us into the darkness? I think because he wants to show us something.

What does he want to show us? (If we could figure that out, maybe we wouldn’t need to go into the darkness at all, saving much trial and effort). I think it depends.

  • Ezekiel saw a valley of dry bones and God showed him how Ezekiel’s words could turn it into living army.
  • Hosea saw a ‘Valley of Achor’ (is that bitterness or despair) leading to a door of hope
  • Caleb’s daughter-in-law, in words that resonate down the centuries, asked Caleb, ‘if you give me the desert, give me also streams of water. ‘
  • Joseph, exiled, jailed, and then part of the Egyptian government (led where he did not want to go) called one of his children ‘fruitful’ because ‘God has made me fruitful in the land of my suffering. ‘
  • Peter was told ‘you will be led where you do not want to go’ . In the darkness of a prophesyed martydom, Jesus dealt with Peter’s deepest insecurity, his fear that he would again let Jesus down again at the last.
  • Paul despaired of life but emerged with a deeper realization that God raises the dead.

No-one emerges unchanged. Following Jesus into a claustrophic mine shaft, dark, isolated, cutting your body up rough and with bad air? You would rather not. But he has something to show you.