Social prescribing can be life-changing - Herts Valley

Featured article - 17 July 2017
By Tim Anfilogoff, Head of Community Resilience, Herts Valleys Clinical Commissioning Group

Head-shot of the author, Tim Anfilogoff, Head of Community Resilience, Herts Valleys Clinical Commissioning Group

Social prescribing is a simple idea. About 20% of GP time is spent with people whose worries around debts, benefits, or housing may make them ill (or undermine their ability to manage an existing condition). Many GPs don’t know how to help. So these patients, who have limited social networks, present time and again. Social prescribing breaks the cycle, bridging the divide between NHS and community. Linking people back to their communities is a sustainable way of reducing demand.

Hertfordshire has had elements of social prescribing in place for years. A wide range of voluntary organisations (from Citizens Advice Bureaux to Age UK; from Carers’ Organisations to befriending schemes) do excellent work and Public Health has funded initiatives like Health Walks. But although there are 12,000+ community groups on the county database, access has generally been random.

In 2010 Hertfordshire County Council and the Primary Care Trust commissioned a new service, HertsHelp, to provide a single point of access and expert triage. Yet GPs were making five per cent or less of the referrals to HertsHelp. In 2014 Herts Valleys Clinical Commissioning Group and the council used funding from the Better Care Fund for a new community navigator service to take referrals from GPs and to work face-to-face with more vulnerable clients. It started focusing on what matters to them (to help them manage what is the matter with them). Being ‘on the ground’ they build excellent relationships with GPs. In West Herts, for instance, HertsHelp triages all referrals. This now stimulates 12 times as many referrals from GPs to HertsHelp as in other areas.

The Sustainability and Transformation Plan has embraced social prescribing, within its prevention programme (but linking closely with the place-based care workstream), identifying assets and designing a new systemic approach. This has seen Hertfordshire County Council even providing extra funds from the Improved Better Care Fund.

Nearby, in West Essex, a new integrated commissioning approach started in April. It’s called Smart Life and is a pilot programme that aims to help people to build their self-confidence, remain independent and live healthily and safely in their own communities. This sees community agents and the Essex Lifestyle service working together seamlessly, with triage through the West Essex Care Navigation Partnership. Similarly in Herts we are expanding the community navigator service and integrating it with various hospital social prescribing projects. These are all linked together through the crucial infrastructure of HertsHelp. We expect additional value to be released from existing systems through these enhanced partnerships.

A new social prescribing toolkit from NHS England - and a summary of social prescribing evaluations - will be published soon. This will inform public health’s design of a single system evaluation tool for social prescribing across the Sustainability and Transformation Plan footprint. This will be integral to the enhanced service that will run from 01 October. Patients tell us all the time that social prescribing can be life-changing for them. Formal evaluation will help establish the case for social prescribing’s crucial role in transformation. So social prescribing is a simple idea, but a really important one.

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