A GP says patient appointments by ‘regular attenders’ have dropped since she spearheaded a range of new services including a wellbeing clinic, free yoga, massage and coffee mornings to tackle loneliness and isolation.

Laura Coia is determined to improve the physical and mental health of patients who attend her surgery in Auchinairn, on the outskirts of Glasgow, with a weekly blog which encourages the public to make 2019 “a year of small changes.”

She organised an all-day coffee morning in the practice to help foster community spirit and also made sure no one spent Christmas Day alone by linking up with hotels and restaurants offering free meals.

Laura, 40, says that while she is now seeing less of patients she tends to see more regularly, her list of new referrals has increased.

She said: “At the moment I’m actually seeing more patients because word gets out that if you are having problems with your mental health or stress or if you are wanting advice on weight loss, go see Dr Coia.

“What I have seen is that patients who I was seeing a lot of, I’m seeing less of them and it’s a much more positive consultation. 

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“If it was to list the top problems I see it would be fatigue, being overweight, anxiety and depression. Just generally feeling rotten.

“I see massive numbers of people with obesity and diabetes. 

“The patients I see who want to lose weight, they might not have lost significant amounts but what I’m seeing is, they are much more mobile, they have better relationships.

“Their wellbeing is so much more improved that it’s not all about eating. Over the next year I’m hopeful I’ll see a difference.

Read more: Three diabetic patients a week in Glasgow get amputations 

Laura also launched a weekly blog and website dedicated to health and wellbeing which includes a range of advice from her, Izzy Howa, a consultant in diabetes and endocrinology and Grant Yuill, a personal trainer.

She said: “A simple blog could be to say to patients to go down to Aldi, see what is on the ‘Super Six’ vegetables and challenge yourself to make something out of it.

“It changes every week so you won’t just be eating the same vegetables every week.

“We know that little changes are easy to make and easy to sustain and what we are saying to people is, don’t set yourself up for a fall.

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“If the only change you do is eat more vegetables you are going to be doing something really good for your health.”

Tackling anxiety and depression related symptoms can be the most challenging part of her job, she says as the root of the problem can be multi-layered.

She said: “Often what people are looking for is an easy answer, to be prescribed something for their low mood or fatigue.

“It’s just trying to get people to buy into it because the general public still want to come and see their GP.

"They don’t understand there might be other people better equipped to help them. It sometimes takes three or four appointments to persuade them that that isn’t the answer and there’s a need to make some small changes to their lives.

“The wellbeing clinic is a good way of supporting that She can also refer people to a yoga class, which runs on a Monday in Auchinairn community centre. It’s free and runs for an hour.

“The patients that I know that go, I’m now seeing less of them. I have a patient with fibromyalgia who goes to the yoga group and she said it had changed her life.”

“If someone comes in with mild anxiety and depression there is not a lot of evidence to show that antidepressants will help them.

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“If there symptoms are mild, and even if they are asking for anti-depressants, I’ll very much try to suggest other things. 

“We have a wellbeing advisor, who is from a social care background who comes in once a month.

“She can help with financial advice, she can help accessing foodbanks and she can also help access a dementia cafe etc.

Read more: Calls for takeaways to offer healthier alternatives for children

“I’m probably referring two or three people a week and there are probably more who could benefit but it’s trying to persuade people, when there is no easy answer. I see so many patients complaining about tiredness.

“I say to people about 10 times a day, you have to look after you or everything else will fall apart.

There is also a wellness wall in the practice, which changes weekly and might direct patients to local walking groups or remind women to have a smear test.

Laura admits her own health was in need of a re-boot before she had her three children, who are all at primary school.

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She said: “Before, they would have seen me snack a lot, have terrible portion control. I wasn’t very active.

“What they now see, hopefully is someone who just sees exercise as part of their daily life. I grew up in a house where there was terrible portion control.

“They now know what a normal portion is.  They do get snacks and treats but they associate it with being physically active.

“If you as a mum are going to a slimming group, you need to have all the family eating the same food.

“I’ve got no issues with anyone following an eating plan as long as it’s something you can follow until the day you die.”

Laura’s practice does not qualify for deep end funding, which allocates cash to surgeries in Scotland’s 100 most deprived patient populations for extra services such as financial advice, because the catchment area does not meet the deprivation quota, but she accesses funding streams where she can.

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The Scottish Government recently announced a further £20million is being made available for GP practices to access loans to introduce additional services in the practice.

She said: “We’ve got quite a mixed demographic, we’ve got lots of patients from Bishopbriggs, which is quite an affluent area, and we also cover Torrance, Robroyston and Springburn.

“We’ve got a lot of elderly people in Bishopbriggs and in Springburn and other areas we’ve got a lot of young, unemployed.

“Compared to the rest of East Dunbartonshire, we’ve got bigger issues with unemployment and drug and alcohol abuse so we need to ensure that the care we are providing is not just matching what is available across the rest of the area.

“We have had to make some changes in our practices.

“We have had lots of support from Healthcare Improvement Scotland.”

And the self care advice does not just extend to patients. GPs at the practice meet for a coffee break every day for 20 minutes at 10.20am and there is also a walking group for staff.

Last Christmas, Laura arranged for some patients who were spending the day alone to have dinner in a local hotel and also organised a coffee morning to tackle loneliness in the practice, which ended up lasting all day.

She said: “We made list of patients who were vulnerable and phoned them. Everyone who was a patient that day was there and all the patients from the list came in.

“It was so well received. One person was there for four hours, the girls went out and got her lunch. She was lonely and needed somewhere to go.”

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