What is Social Prescribing?

Recognising that people’s health is determined primarily by a range of social, economic and environmental factors, social prescribing seeks to address people’s needs in a holistic way. It also aims to support individuals to take greater control of their own health.

Social prescribing schemes can involve a variety of activities which are typically provided by voluntary and community sector organisations. Examples include volunteering, arts activities, group learning, gardening, befriending, cookery, healthy eating advice and a range of sports.

There are many different models for social prescribing, but most involve a link worker or navigator who works with people to access local sources of support. Link workers give people time, focusing on ‘what matters to me’ and taking a holistic approach to people’s health and wellbeing. They connect people to community groups and statutory services for practical and emotional support

Who are social prescribing link workers?

Social Prescribing link worker is a new role, so it is unlikely there will be lots of applicants who have done the job before. However, there will be many people with transferable skills and experience that would be attracted to this role.

  • Worked with people with support needs previously in a key worker/ case manager type role and those who have a broad understanding of the wider determinants of health
  • Supported and motivated people to make changes in their lives, helping the person to make plans based on what matters to them
  • Strong active listening, communication and engagement skills
  • Aware of and understand the different systems of advice and support that are in place around health, care, housing, employment, benefits, volunteering and how to navigate them.
  • Building a rapport and trust with people
  • Listening to what matters to them
  • Helping the person to develop a personalised support plan
  • Knowing the services and support networks available in an area
  • Connecting people to services/ support (formal e.g. commissioned services and informal e.g. groups, clubs, networks)
  • Supporting the local community to set up new activities e.g. walking group, gardening club at community centre, coffee morning etc

What patients would be suitable to be referred to a social prescribing link worker?

Social prescribing works for a wide range of people, including people:

  • with one or more long-term conditions
  • who need support with their mental health
  • who are lonely or isolated
  • who have complex social needs which affect their wellbeing.

From a GP perspective practice teams should consider those patients that are frequent attenders with often unexplained physical symptoms, social isolation, mental health difficulties, and poorly controlled long-term conditions.

What evidence is available on the impact of social prescribing link workers?

Evaluations of local social prescribing schemes have reported reduced pressure on NHS services, with reductions in GP consultations, A&E attendances and hospital bed stays for people who have received social prescribing support. In 2017, the University of Westminster published an Evidence Summary, which identified 28% fewer GP consultations and 24% fewer A&E attendances for people receiving social prescribing support.

https://www.westminster.ac.uk/patient-outcomes-in-health-research-group/projects/social-prescribing-network

How do Social Prescribing Link Workers fit in with commissioned services that are already in place to help with social issues?

Cambridgeshire and Peterborough already have a range of commissioned services and support in place that will complement the work of the Social Prescribing Link Workers by providing services for them to link patients to. There are also voluntary sector organisations that act as the single point of contact for GP’s to refer into (Health and Wellbeing Network for Cambridge, Hunts and Fens and Peterborough Wellbeing Service in Peterborough).

These services are commissioned by the CCG to take referrals from GP Practices and triage and connect patients to services and support. The Health and Care system is reviewing how these services may need to adapt their offer once Social Prescribing Link workers are in post, recognising the duplication of effort and at the same the important role they have in supporting and developing a buoyant voluntary sector market through attracting additional investment and ensuring communities have someone to go for support to develop new groups and activities in their local area.

What’s the difference between social prescribing and active signposting?

“Active signposting” schemes generally involve existing staff in general practices, libraries and other agencies providing information to signpost people to community groups and services, using directories and local knowledge. They offer a light touch approach which works best for people who are confident and skilled enough to find their own way to community groups.

Social prescribing is different in that it focuses its support on people who lack the confidence or knowledge to approach other agencies or to get involved in community groups on their own. The personalised support of social prescribing link workers gives people time and confidence to work on the underlying issues which affect their health and wellbeing.

What does the day in the life of social prescribing link worker look like?
09:15 First patient appointment at Practice 1 of a Network of 4 Practices. 45 min assessment using a C and P standardised assessment tool to frame our discussions. First time the person has had the time to talk about the things in their life that are causing stress, anxiety and worry. Actively listen to each in turn asking questions about how they would like things to be different. Agree to meet again next week to start pulling together a plan and for them to spend some time this week thinking about what their priorities are to change first and why.
10:00 Patient 2 was assessed two weeks ago. This is their 3rd appt. Last week we developed a plan, prioritising the things that matter most and identifying some organisations that may be able to help her. We discussed how her appointment with Citizens Advice went to discuss her debt. She advises she did not go the appointment as was too nervous. We explored what he fears were. We rearranged the appointment with Citizens Advice and agreed to go together.
10:45 Three more 45 minute patient appointments.
13:00 Lunch
14:00 Visit to meet Hindu Temple that provide a range of social activities in the area around the Primary Care Network that I work in. Agreed how best to link patients in to this service and shared my contact details should they want to get in touch.
15:15 Met a patient at Practice 2 in the Network. Gave them a lift to a mental health charity who run a drop in service at the community centre. Introduced them to the worker who would be working with them that day. Made sure the worker had seen my referral so no need to re-assess. Left patient and worker discussing activities that they might get involved in.
16:00 Practice meeting at Practice 3 – gave a short presentation to admin and reception staff about my role, what we do, the patients we support and how to refer patients in.
16:30 Used hot desk in Practice 3 to write up patient notes on clinical system, clear tasks and check diary for tomorrow.