How to Prepare for Social Prescribing in your PCN
GPs are increasingly spending time dealing with patients’ social problems such as loneliness, debt and housing issues. In fact, one in five GP appointments are about non-medical needs. These issues can manifest themselves in mental and physical symptoms that increase the workload on GPs and the wider system. For example, patients with chronic conditions spend an average of four hours a year with a clinician.
Social prescribing is a channel that GPs can use to help these patients with non-medical care and is part of the NHSE Long Term Plan which was launched in January 2019. From this month, all Primary Care Networks (PCNs) will have funding for 2019-2020 to commission at least one social prescribing link worker to their network.
With plans moving quickly (the NHS has a webinar on social prescribing this month and a series is planned for September), we thought we’d share what we at Miad Healthcare know about the NHS’ plans and the role of social prescribing link workers.
What is social prescribing?
Social prescribing is a way of connecting people with access to local community groups and agencies for practical and emotional support. This could include healthy eating advice, volunteering, sports and exercise groups, gardening, arts activities and group learning. Social prescribing is designed to help people with long-term conditions, who need mental health support, who are lonely or isolated or have complex social needs.
What’s the plan?
Social prescribing link workers will become part of the multi-disciplinary teams within PCNs. As part of the drive towards more personalised care, NHS England is planning for 1,000 new social prescribing link workers by 2020/21. By 2023/24 it is anticipated that at least 900,000 people should have been referred to social prescribing.
Does it work?
Overall feedback is positive, but there are few studies from which we can draw conclusions. A 2017 British Medical Journal paper came to positive conclusions but acknowledged that “current evidence failed to provide sufficient detail to judge either success or value for money”.
Anecdotal and qualitative evidence shows social prescribing is very well liked by patients and GPs. For example, Storrsdale Medical Centre in Liverpool began hosting tea parties for isolated patients . This has shown positive results for individuals, GPs and the community.
Does it relieve pressure on GPs?
A study by the University of Westminster found that social prescribing was associated with a 28% reduction in GP appointments and a 24% reduction in A&E attendance and outpatient referrals. However, the study reported similar limitations to the BMJ study: “it would be premature to conclude that a proof of concept for demand reduction had been established.”
Social prescribing is one of the Royal College of General Practitioners 10 High Impact Actions, This report finds that 59% of GPs think that social prescribing could reduce workload. However, GPs also highlighted that without adequate information about charities, community groups and local services, social prescribing will not have a significant impact.
What does the role entail?
Like many roles in healthcare it’s complex, demanding, and rewarding! Responsibilities include being able to:
- provide personalised support to individuals, their families and carers to take control of their wellbeing, live independently and improve their health outcomes;
- develop trusting relationships by giving people time and focus on ‘what matters to them’;
- take a holistic approach, based on the person’s priorities, and the wider determinants of health;
- co-produce a simple personalised care and support plan to improve health and wellbeing, introducing or reconnecting people to community groups and statutory services; and
- evaluate the individual impact of a person’s wellness progress.
As you can see, it’s quite a complex and responsible role! Guidance from the NHS shows that link workers will typically work with people over 6-12 contacts, over a three-month period, with an average annual caseload of up to 250 people. Some of this activity will involve home visits and introducing people to community groups. The average salary of a social prescribing link worker is £25,000 per annum.
The need for accredited training
Given the reach, impact and complexity of the role it’s important that link workers are trained through an accredited programme and that they receive ongoing development support. The National Association of Link Workers provides guidance on the areas in which link workers need to be confident:
- Mental health support
- Tackling isolation and loneliness
- Working with community groups
- Dealing with deprivation
To achieve this, link workers will need to be knowledgeable about the range of local support available, plus they will need excellent listening and communication skills, empathy and emotional resilience.
In addition to training, link workers will need a programme of ongoing development and support. This must include access to clinical supervision and manager support in dealing with people in crisis and vulnerable situations. Given the planned acceleration in the recruitment of link workers, it’s important that there is a joined-up approach to supporting and developing this role in our PCNs.
Miad Healthcare’s Social Prescribing ‘How To’ workshop
As you embark on recruitment of your first link worker, or even if you already have link workers within your PCN, our half-day Social Prescribing ’How To’ workshop will provide Practice Managers with the information and guidance needed to support the Social Prescriber in their developing role as well as the opportunity to share best practice and develop ideas with like-minded colleagues.
To find out more about Miad Healthcare’s Social Prescribing workshop, please get in touch.