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.

Harmless as doves

Sneaky but effective

Photo by Shubhankar Bhowmick on Unsplash

I was struck recently by the phrase ‘Wise as serpents, harmless as doves’. I must admit that I think the ‘wise as serpents’ bit comes a lot more easily to me (wily, crafty, political) than the ‘harmless as doves’ word.

It means that at a certain point, after you have done all your wise-as-serpent stuff, you are defenceless. You are approaching people with innocence. You are choosing to believe that somewhere inside them, nestled among the faults you see, is a shred of decency. Somewhere deep inside is a concern for the welfare of others. And we are to approach them, or when not actually approaching them but just thinking and talking about them, we are to treat them is if that shred of decency really was inside them, and can be awakened by someone who believes against the odds that it is there.

The Lord Jesus, I think, had the childlike innocence when threatened. Pilate: ‘Are you the King of the Jews’? Jesus: ‘Your words.’ Or after being hit in the face when being questioned by the High Priest: ‘If I spoke evil, show me. If I didn’t, why did you hit me?’ Both times, I think, he’s probing inside the other person to justify what they just said or did, not slandering or insulting them; his innocence is disarming and unnerving.

It feels weak. But in fact it is a deadly infusion of grace that they may not know how to handle. They are used to fighting, being opposed, lobbing ordinance from their trench. They are not used to being told, by someone who opposes them, that they have a difficult job and perhaps they could be doing it better.

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.

Appealing against the Second Law

I’d like to protest the passing of time.

Photo by Elena Koycheva on Unsplash

It’s a humane feature of earthly laws that you can appeal.

The law I’d really like to appeal against, though, is the Second Law of Thermodynamics, which is roughly, everything gets old, wears out dies.

I’ve had it with seeing what Time and the Second Law do to people. What is this force that takes good people, drains them into a wizened hulk, then tosses them aside? How can that be right? I wish to appeal on behalf of the spry 85-year-olds I know who any time soon will hardly be able to climb onto their perch, and a little later, will have fallen completely off it. Good, strong people. Old age so isn’t fair.

Can you appeal? A lot of people, most of us, try to defy the Second Law or hold it back. It doesn’t really work, of course. But can you actually appeal? Since we are dealing with the created order here, we would have to appeal directly to the Creator. And we have a clue in our favour, namely the life, death and resurrection of God the Son, Jesus Christ.

So our appeal. Best to bring the issue to the One God and ask him to think about it in the light of his total Godness. That is, just be God, God. In all your total love, justice and mercy, faced with these things that you created, namely (1) the Second Law, and (2) people made in your image, made in your love, just be totally yourself.

If one can so speak.

And when you do that, what results? I don’t think we really can know. But I’m thinking, if the appeal is granted, and I can see how it might be, the eternal state that results isn’t just about halting time’s flow. I would quite to have my twenty-three year-old body back (halting time in that sense) but I’d quite like to hang onto my much older head, please. And when I think about it, the pattern of childhood, youth, midlife, old age, each with their attendant joys, are all lovely and I wouldn’t like to miss any of them. I wonder if Eternity will be still be roiled by the slowly passing seasons? I kinda hope so.

But it that’s the case, and if you appeal to God against the Second Law, asking God to be totally God in all of this, what does a successful appeal look like? I think it looks like hope, new birth, regeneration.

The really bitter thing about the Second Law is not really the ageing, or the weakening, or the becoming erratic and vulnerable. All that can be covered by love, at the end of life, just as it is covered by love at the beginning of life. No, the really bitter thing is when people fall away into a dark pit of hopelessness. So that I will never see them again. I will never know them again. I will never enjoy them again. We will never talk together again. Never again.

But if the wizened elderly were in fact seeds ready for a new planting, ready for a new life, still the essential them, but re-made for a new dawning world, all the losses on this side of things would be OK.

Slowness and labour-saving devices

There is an argument that commitment to going about things slowly means should shouldn’t surround yourself with timesaving kit. I mostly don’t agree. As well as the standard stuff that everyone has had for years, we’ve also introduced a breadmaker and then a robot vaccuum cleaner to our managerie.

They mean you can choose your slowness. Making bread with a breadmaker is huge fun, a world away from the chore of having to make it like my grandparents knew.

I was thinking the other day about pre-dishwasher days. They mostly coincided with my not-being-married days, and quite often with being invited for Sunday lunch. As a young guy and recent Christian I ate a lot of other people’s Sunday lunches, usually a roast, and typically followed up by a walk or a chat and then a tea. Along with others, I have gratefully tackled piles of washing-up, enjoying the conversation and the shared work. I found various species of washers-up over the years, all now sadly ghosts of history.

  • The perfectionist. This was someone who basically took charge of the sink and made sure every dish came out spotless and gleaming. They were not quick, and their fellows on the cleanup crew had to stand and wait.
  • The drier-up who gleefully, even maliciously, returned washing up to the sink, requiring it to be redone.
  • The drier-up who assumed if you pick it off with tea-towel, that’s just fine.
  • The enthusiast who splashed around like a toddler in a bath, soaking everything, washing up with speed but not always with the highest quality.
  • The mono-tasker who, if you asked him a question, would stop even drying up a plate while he thought about the answer.
  • The contrarian, who washed the dirtiest things first, using prodigious amounts of water and time.

On that spectrum I was definitely, as a washer-up, the enthusiast, and as a drier, the picker-off-with-the-teatowel, unless I really didn’t like the person washing up, in which case I returned every plate I could find.

So much is lost with the demise of the Sunday wash up. Psychological assessment. Control. Submission. Dominance. Mentoring. Shared endeavour. Friendship.

Still, though.

Unpolitics

and breathe…

AI-generated image by Craiyon

We have had a lot of politics in recent years, or maybe it’s just me, but I found Keir Starmer’s first words outside Downing St on July 5th 2024 refreshing:

To restore service and respect to politics, end the era of noisy performance, tread more lightly on your lives

I am not missing (in the UK scene at least) the burlesque, the cries of ‘look at me!’ and the fighting over who gets to drive the clown car.

Even if the UK has temporarily rounded up the pub-bores who were roving wild and swinging like apes on the levers of power, unworthy people remain in charge in many other places around the world. You can feel depressed and powerless in the face of it.

Perhaps we needn’t, though. I am reading through, for the second time, Richard Bauckham’s book ‘The Theology of the Book of Revelation.

Really keen readers of this blog will know that I have wanted to read this volume for some time, and I have finally managed to do at a decent price via my subscription to the wonderful Perlego. Prof Bauckham wades into the Book of Revelation, disdaining the many authors and preachers who treat it as their own clown car. He is Scots-Presbyterian sober, theologically focussed, academically on top of things, devotionally hearted, and every dry paragraph can be mined for the good stuff.

It’s political. The rest of the New Testament, in my reading, isn’t really. The Roman Empire is a given. Luke, in particular, is keen to show the reasonableness of Roman rulers when he can. But all that political tiptoeing gets shoved out of the way in Revelation. Rome is a harlot, Babylon, wiping her mouth between lovers. The cultural discourse that accepts all this is a false prophet. They won’t be reformed. They are heading for the lake of fire. They will be entirely replaced with the City of God: a city still, but one not wormy with exploitation and injustice.

Prof Baukham notes a fascinating thing. What gets us to that happy place is not ‘politics’ but faithfulness. Not politics but ‘unpolitics’ perhaps.

In Bauckham’s telling, Revelation’s visions teach theological truth. Seals are broken on the scroll of history, and along come disasters on a quarter of the earth. But nothing shifts. Trumpets blow, and along come disasters on a third of the earth. And nothing shifts. Seven thunders roar (perhaps heralding disasters for half the earth) but they are held off. Why? Disasters don’t lead to lasting change, to repentance. What does make a difference? When you add to the disasters the faithful witness of the Church. That’s the picture in Revelation 11 of two prophets (you need two witnesses to establish a matter) who are martyred. Everyone parties initially. The ‘world’ has won. But then…

But after the three and a half days the breath[b] of life from God entered them, and they stood on their feet, and terror struck those who saw them. 12 Then they heard a loud voice from heaven saying to them, “Come up here.” And they went up to heaven in a cloud, while their enemies looked on.

13 At that very hour there was a severe earthquake and a tenth of the city collapsed. Seven thousand people were killed in the earthquake, and the survivors were terrified and gave glory to the God of heaven. (Revelation 11:11-13)

A great universal repentance follows the martyrdoms. In a reversal of Elijah’s day (when a remnant of seven thousand was preserved) a remnant of seven thousand is lost but the rest give ‘glory to the God of heaven’.

This theme recurs in Revelation 14 when there are two harvests, one, ‘the harvest of the earth’ for gathering the good grain into the barn; another for grapes for the ‘winepress of God’s wrath’.

And it recurs again in Revelation 15 where the faithful witnesses re-write the Song of Moses (sung after the Exodus) for a new and better deliverance:

Who will not fear you, Lord,
    and bring glory to your name?
For you alone are holy.
All nations will come
    and worship before you,
for your righteous acts have been revealed.”
(Revelation 15:4)

What brings the monumental change? What makes ‘all nations’ come? The faithful witness of God’s people. I absolutely love this.

Of course there is a calling and obligation for some people to serve in politics. But for the rest of us, deep, lasting change at the national level is brought about by what? By living faithfully for Jesus and bearing testimony to him. This is the mountain-moving act. Slow, steady, patient … this is the mountain-moving act.

In the United States, at the moment, the New Apostolic Movement is busy ‘mapping spiritual strongholds’ and seeking to overthrow them. (As described in a fine piece of journalism in The Atlantic.) They are hungry and zealous for God and for reform. I unfortunately believe they are being played by the current President Elect, who has co-opted them. I studied under Pete Wagner, the first and most influential academic to write about this stuff, and I appreciated Pete Wagner, but I do not agree with him here. It isn’t revolutionary holy struggle that gets us Christians where we want to be. It isn’t ‘spiritual mapping’. It isn’t politics as such–politics follows the path others have beaten down.

It is faithfulness.

We know this from the psalms:

Do not fret because of those who are evil
    or be envious of those who do wrong;
for like the grass they will soon wither,
    like green plants they will soon die away
.

Trust in the Lord and do good;
    dwell in the land and enjoy safe pasture.
Take delight in the Lord,
    and he will give you the desires of your heart
. (Psalm 37:1-4)

Unpolitics. The superpower.

Making things whole (in a crumbly world)

With a cherry on top. Photo by Nik on Unsplash

We are all at it. It’s extraordinary.

I’m willing to guess that whatever you do, making things complete and whole is a big part of it. The passion unites hotel bed-makers and people not burning toast and people launching space probes. Or doctors or plumbers or interior designers or teachers or graphic artists or anybody.

It’s so deep inside us: make things, perfect things, complete things, tidy things up, sort things out. Make things whole. The meal isn’t cooked (as I am sometimes reminded) if the surfaces aren’t wiped and peelings have fallen into the cutlery drawer. A bike isn’t fixed until it’s fixed. A life isn’t complete if it didn’t end well. The baby needs a clean nappy and nice clothes and to look cosy and happy. The books aren’t complete if they don’t balance. All over the world, if we could just hear it, is the sound of things being sorted out, done properly, made neat and tidy, finished, polished, dusted, double-underlined, with a cherry on top.

This is all the more odd because we live in world where everything crumbles, wears out, has its day, breaks, tarnishes, rots; or is anyway deeply flawed, provisional, partial, compromised and just not quite completely whole.

I’ve been reading the Old Testament scholar John Walton and his take on creation is that God’s involvement in it, as described in Genesis, is giving it form and function and then co-working with humans to turn back the chaos. It’s a bit of a setback when humans imbibe the chaos and become both part of the problem as well as part of the solution; a solution finally only resolved by, and in, Christ.

Here’s a fun thought though: when we (attempt to) make things whole, nothing speaks more loudly of God’s image inside us. Nothing is as fulfilling, as satisfying, as purposeful, as setting out to do something properly and succeeding. Nothing is so good for our mental health. Even if it’s just getting dressed. Every time, it’s like we’re answering some distant call from God.

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?