Guest blog by Lynda Thomas, Chief Executive of Macmillan Cancer Support. Lynda is the chair for the National Steering Group for our Doing the Right Thing Programme.
You know momentum is building behind a social movement when it gets its own day, it's great to see the first Social Prescribing Day launched today.
Social prescribing recognises people’s health is not only determined by physical factors but by a range of social, economic and emotional ones. After all, research shows that around one in five patients consult their GPs for what is primarily a social problem. In practical terms, the scheme enables GPs, nurses and other primary care professionals to address people’s needs in a holistic way by referring them to a range of non-clinical services.
Most social prescribing models connect people with a link worker who helps them identify their needs and access local sources of support typically provided by the voluntary and community sector such as arts, gardening, befriending, cookery and a range of sports.
Social prescribing has the power to change lives as the case of Boyd, an MS patient in his 60s, shows.
After suffering a stroke, Boyd was unable to walk and dependent on carers to get out of his flat as he had no wheelchair. At his lowest point, Boyd felt suicidal, trapped and physically unable to pay his energy bills. He was referred to the British Red Cross Connecting Communities where his link worker Ashok Pursani who helped him get a grant for laptop from the MS society, which allowed him to pay his bills online, as well as a Red Cross wheelchair which enabled him to go shopping and socialising. Boyd said: ‘Ashok hasn’t just helped me turn my life around but has become a good friend as well.’
Since Social Prescribing Day was announced last November, the Loneliness Strategy, the NHS Long Term Plan and the NHS Comprehensive Model for Universal Personalised Care and the latest GP contract have all included social prescribing as a core plank in a health and care system that supports people to live as well as possible.
The Richmond Group has warmly welcomed these recent announcements. This coalition of 14 charities who make up the group know that any drive behind social prescribing is good news for people living with the long-term conditions that our organisations represent. We strongly believe social prescribing should be routinely available across the country which, unfortunately, is not currently happening.
The group also welcomed the January NHS commitment to train over 1000 new social prescribing link workers to be in place by 2020/21. This would be vital in realising the ambition that by 2023/24 over 900,000 people will have been referred to social prescribing schemes.
In some areas where social prescribing is already happening, these link worker roles are known by different names. For example, where the Richmond Group has been working in Somerset, in partnership with the Sustainability and Transformation Partnership (STP), there are ‘village agents’ and ‘health connectors’. Across the country, the British Red Cross has many community connectors and my own organisation, Macmillan Cancer Support, works with local areas to support ‘care navigators’ to help people access the help they need.
The voluntary sector must play a huge role with Commissioners and social prescribing. Alongside these link worker roles, the voluntary sector can help map what is already in place in an area and help Commissioners as they look to start or scale up social prescribing services to make sure they build on and learn from the existing infrastructure rather than starting from scratch.
An extra 1000 link workers in place will be a robust resource and could make a vital difference. But for social prescribing to work as well as it possible can, the infrastructure and local networks providing the different type of support needs to be in place. This infrastructure cannot be assumed, it needs to be mapped and resourced by local commissioners. A transfer of resources in to the third sector to deliver this support is one of the essential components of social prescribing.
The Long Term Plan mentioned people living with multiple conditions as the majority of those who need health and care services will have more than one condition. Our recent ethnographic research, done with the Royal College of General Practitioners and Guy’s & St Thomas’ Charity through our Taskforce on Multiple Conditions, shows that we need to dramatically improve the way we help people with more than one long term physical or mental health condition live better.
People talk about the compound impact of their conditions on their day-to-day life, not necessarily about their individual diagnoses. For instance, for many people reduced mobility can limit social connectedness which, in turn, can affect their mental health. These are the sorts of concerns that can’t be easily addressed with a purely medical lens but are about someone’s wider circumstances and the social, emotional, practical support that might be available to them to help them get on with their lives.
We hope Social Prescribing Day will raise awareness of this model so that people who need to are referred to a link worker who can connect them to the right networks. Doing this will empower people to look for solutions to social problems before a mental or physical crisis, as well as support those with one or more long-term conditions to build self-management and coping skills and to maintain independence. This, in turn, has the potential to reduce stress on primary care services.