welcome and mind body... · 2018-03-26 · draft social prescribing plan on a page aim: to make...

Welcome and overviewCatherine Wells, Lead Governor, NSFT

Gary Page, Chair, NSFT

www.england.nhs.uk

Social Prescribing – an overview

Tim Anfilogoff and Siân Brand

East of England Social Prescribing Network

www.england.nhs.uk

Telegraph 27/12/17

“Rather than 'a pill for every ill', social prescribing is a new way of helping certain people get better and stay healthy.”

Simon Stevens quote:

www.england.nhs.uk

• It’s about connecting people for wellbeing

• Asset-based community development -

what’s already there – build on it

• Collaborative: everyone around the table,

including local authorities, VCSE sector, CCG,

primary and secondary care

Why social prescribing?

www.england.nhs.uk

Social Prescribing Connector schemes

– link workers

Community Wellbeing

Hubs

Active Signposting

What do we mean by social

prescribing?

www.england.nhs.uk

• NHS England priority: to enable every local area to commission a

social prescribing connector scheme (often hosted in the VCSE sector)

• Employs link workers, recruits volunteers

• Gives people time, builds trust, based on what matters to them

• Develop shared plans – connect people with community support

• Support community groups and assets

• Takes referrals from all GP practices and other health professionals

Social Prescribing Connector

Schemes

www.england.nhs.uk

• People who are lonely or isolated

• People with long term conditions

• People who use the NHS the most

• People with mental health needs

• Those who struggle to engage with services

• People with wider social issues: debt, housing,

relationships

Most suitable for:

www.england.nhs.uk

• Link workers / connector schemes help and prevent – Gloucestershire

75% of people using sp schemes have mental health needs

• People referred to mental health services – great examples emerging of

social prescribing alongside existing services (Rotherham, Creative Minds in

South West Yorkshire Foundation Trust)

• Recovery colleges empowers people with mental health problems to

become experts in their own recovery

• NHS England is about to create a development programme in partnership

with Defra, to connect people with mental health needs to environmental

therapy.

Support with mental health

www.england.nhs.uk

Conducted by University of Westminster:Impact of social prescribing on demand for NHS Healthcare.

They found an average of 28% less GP consultations and 24% less A&E attendances, where social prescribing ‘connector’ services are working well.

Demand on secondary care services

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

On the person: is their well-being improved?

On the community: Are communities stronger as a result? More volunteers?

Impact Evidence Review

www.england.nhs.uk

Challenges moving forward

Enabling spread with limited funds – so that social prescribing

connector schemes are in every local authority / CCG area

Supporting shared leadership - nurture bottom-up collaborative

partnerships

We should not assume the voluntary sector is free and always there

– build in support and funding

Building the evidence base – everyone measuring the same things – so

that we can make long-term comparisons

We should not over-professionalise social prescribing – it’s about human

relationships – putting community and people at the centre

www.england.nhs.uk

Increase local connector schemes

Produce an online resource repository and bite-sized

resources

Work with CCGs to map local SP connector schemes

Work with Integrated Care System demonstrator and

test sites

Support the DH Health and Wellbeing Fund

Build the Evidence

Base

Develop a Common Outcomes Framework for

Measuring Impact

Commission an in-depth Evaluation of Social

Prescribing Connector Schemes

Put SP codes in General Practice IT Systems

Explore whether SP referrals can be the NHS

BSA Prescriptions dashboard

Help leaders to develop and plan

Develop Regional Social Prescribing Networks

Support the creation of a Quality Assurance Framework

for SP Connector Schemes

Work with Defra to support mental health providers to

connect people to the environment

Develop and pilot learning for link workers

Draft Social Prescribing Plan on a PageAim: To make social prescribing more systematic and equitable, by supporting the spread of local social prescribing connector

schemes, which employ link workers, help people around ‘what matters to them’ and connect them with community support.

www.england.nhs.uk

Social Prescribing – in the news!

Guardian Newspaper (21st February 2018):

The town that’s found a potent cure for illness – community!

Frome in Somerset has seen a dramatic fall in emergency hospital

admissions since it began a collective project to combat isolation.George Monbiot

https://www.theguardian.com/commentisfree/2018/feb/21/town-cure-illness-

community-frome-somerset-isolation

Daily Mail Newspaper (21st February 2018):

Lonely patients are being 'prescribed' coffee mornings, singing

classes and dance lessons to tackle social isolationSophie Borland

http://www.dailymail.co.uk/health/article-5415725/Lonely-patients-prescribed-

coffee-mornings.html

www.england.nhs.uk

‘Making Sense of Social Prescribing’ - Guide https://www.westminster.ac.uk/patient-outcomes-in-health-research-group/projects/social-prescribing-network

National Social Prescribing Network email: socialprescribing@outlook.com

https://www.westminster.ac.uk/social-prescribing-network

NHS England – Repository ContributionsEmail: england.socialprescribing@nhs.net

East of England Social Prescribing Facilitators:Tim Anfilogoff email: tim.anfilogoff@hertsvalleysccg.nhs.uk

Sian Bran email: sianbrand@livingsafeandwell.co.uk

Resources

Social Prescribing and Community Connectors in

Norfolk

Rob Cooper

Head of Integrated Commissioning

(Norfolk County Council and South Norfolk CCG)

robert.cooper4@nhs.net

Vision

• Access from a range of sources to community based ‘Living Well’ workers/connectors who help people identify their goals and to make plans to achieve them

• Link people to expert, specialist help and support to resolve issues which negatively impact on their ability to stay healthy, manage their health conditions and live independently.

• Help identify appropriate community assets and connect people with communities

• Consistent core service at scale for people wherever they live across Norfolk and Waveney

• Priority for the Norfolk and Waveney STP

Key principles

• Combines consistent approach with local delivery and flexibility

• Delivered at scale, accessible to patients from all GP practices across Norfolk and Waveney and accessible through other routes

• One approach to evaluation built in from the start

• Asset based – utilise existing resources, including those from Local Authorities and existing community groups and voluntary sector

• Makes sense – can be clearly understood by people who could benefit and organisations who can help people to access and links rather than duplicates what is available in a local area. Founded on partnership with voluntary sector and district councils, acknowledging their expertise in this area, building on learning and enthusiasm from current projects

Building on current community assets and initiatives

• Current social prescribing initiatives – LILY (older people in West Norfolk); South Norfolk Connectors; GP led approaches and Neighbourhoods that work in Great Yarmouth; CAB pilot in Tuckswood and Lakenham

• Early help hubs

• Integrated Care Coordinators

• Adult Social Care Development Workers

• Norfolk Libraries projects

• Many current Voluntary Sector and community initiatives

• Support for people who are lonely and isolated

Model supports the innovation social work pilots for Norfolk – ‘Living Well – 3 conversations’

Based on method developed by Partners for Change 3 conversations

• Conversation 1 Listen hard and connect – Understand what really matters to the person. Connect them with resources

• Conversation 2 Work intensively with people in crisis – What needs to change urgently to help someone regain control of their life.

• Conversation 3 Build a good life – What does a good life look like? What assets, strengths, resources (including people with personal budgets) does someone have to support their chosen life?

• This approach moves away from the assessment and care package model of social work. It depends on social workers, occupational therapists and social care staff spending more time with individuals and builds on existing strengths-based approaches adopted by NCC , encouraging social care professionals to connect with the networks and support available in local neighbourhoods and communities.

Work Programme

- £950k per year investment for 2 years

Funding for connectors and some funding for community activities and assets.

July 2017 – Sept 2017: Explore model and options for delivery with wide range of stakeholders.

Sept 2017 – Oct 2018: Establish locality planning groups (key partners District Councils, CCGs, Voluntary organisations, Adult social care, GPs), agree detailed delivery model for each locality; source providers; establish grant agreements with providers; recruit to Connector roles; develop detailed implementation plan with clarity about how connectors will work with existing ‘crossover’ roles; develop and implement strong communication plan; services start; agree governance and implementation of local community funding pots; design joint training.

Sept 2017 – May 2018: Design and establish evaluation framework; develop a detailed business case for Social Investment Bond to be used as a vehicle for some future investment in the model.

June/July 2018: Official launch.

July 2018 – March 2020: Continue to develop, review, adjust, report, evaluate, recommend, sustain where successful (ie Social Investment Bond)

Locality / local models lead providers

Who will provide the connectors in each locality?

North Norfolk – North Norfolk District Council

Norwich and Broadland – Advice led model with 5 advice organisations providing the connectors through Norfolk Community Advice Network

South Norfolk – South Norfolk District Council

Breckland and West Norfolk – A range of VCS providers through Community Action Norfolk

Great Yarmouth – A number of VCS providers through Great Yarmouth Borough Council

Who will the Connectors work with?

Public Health - What influences quality of life, health and wellbeing

Health Inequalities support programme

http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidan

ce/DH_115113

What is the potential impact of

not preventing and/or addressing

certain problems or not

intervening early

enough (preventable disease,

physical conditions, self esteem

and bullying, problems that may

not present until adulthood)?

Possible impacts - health• Reduction in the proportion of GP appointments that are not directly related to

health conditions and which could better be addressed through alternative providers.

• Reduction in the average number of GP appointments among the cohort of patients referred to the wellbeing advisor/connector service.

• Decrease in the number of hospital admissions (inpatient days) among the cohort of patients referred to the wellbeing advisor/connector service, 12 months following referral.

• Reduction in use of 999, accident and emergency attendances among the cohort of patients referred to the wellbeing advisor/connector service?

• Reduction in the number of outpatient appointments among the cohort of patients referred to the wellbeing advisor/connector service.

• Reduction in prescribing of antidepressants to patients referred to the wellbeing advisor/connector service.

• People feel better about themselves and report improvements in wellbeing

Possible impacts - social care

• Improved customer experience with people telling their story once

• Increase in the number of people who are able to remain independent for longer

• Reduction in number and costs of formal packages of support (preventing or delaying the need for some packages) – Average home care package for an older person in Norfolk is £9,189 per year. A six month delay would therefore generate a prevention saving of £4,595 per year. If 5% of packages (260 individuals) were delayed the saving would be c£1,194m

• Improved wellbeing for people receiving targeted information, advice and support (currently around 10,000 people a year)

• Improved effectiveness of NCC’s front door service in finding solutions for people using information and advice

• Reduction in the number of assessments that only result in the provision of information and advice (because information and advice is provided more effectively)

Community Resilience & Social Prescribing:

Colin Baldwin; Suffolk County Council colin.baldwin@suffolk.gov.uk

Social Prescribing is one approach by which we are seeking to deliver our vision of community resilience. Our SP modelling has been influenced by;

5WTWBRtVNational SP Model

Community Resilience and the Five Ways to Wellbeing

http://www.nesta.org.uk/project/realising-value#sthash.0dQb2axc.dpuf

Our work around community resilience, particularly that within social prescribing seeks to follow much of the principles and approaches espoused within Realising the Value.

Realising the Value was a programme funded by NHS England to support the NHS Five Year Forward View.

http://westminsterresearch.wmin.ac.uk/19629/1/Making-sense-of-social-prescribing%202017.pdf

Our thinking in the development of a Social Prescribing Plus model derives from the National SP Model (see link below) and then widening it to site within a wider asset and locality based early intervention and prevention model

Social Prescribing ‘Core elements’ & SP+

Social Prescribing + (Community Connector) ...taking services to people

Kerrie Gallagher

Mind, Body and SoulHealth and recovery through social prescribing

Building on existing foundations:The South Norfolk Help Hub

Help to residents at the earliest opportunity

Reducing the opportunity for crisis and increasing self-help

This is an approach to how we work together – not just about a physical working space

Base in Long Stratton – a space for organisations to work

Single point for request for support

What do Community Connectors do?

Based and operating within local communities; they help people to:• Be part of their community• Have positive relationships• Gain skills and feel confident• Have a warm and safe home• Be free from money worries.

They do this by listening and connecting people to the right places and people

What is Social Prescribing?

Social prescribing schemes:

Offer a non-medical solution to issues that may be causing or exacerbating health problems of patients

Are simple and easy for patients, and professionals to understand and benefit from

Are not in themselves a support service

The service aims to be very much community-rooted

The Perfect Partnering

What does it look like?

Where are we operating ?

How things are shaping up

Customer Perspective

Any questions – please come and

speak to us!

Haverhill LifeLink

Lizzi Cocker

Elaine Hewes

Haverhill LifeLink

http://www.onehaverhill.co.uk/lifelink

Haverhill LifeLink Model

What we’ve learned so far…

Male Female

Continued….

Advice/Finance29%

Social Groups25%Volunteering

8%Active

3%

Statutory services7%

Support Groups7%

Mental Health Support (VCS)18%

Employability3%

PARTNER REFERRALS

Advice/Finance Social Groups Volunteering Active

Statutory services Support Groups Mental Health Support (VCS) Employability

Next steps

Continual development with community groups and activities

Develop work with Department for Work & Pensions

Establish evidence to show reduced demand on health and statutory services

Work with partners to develop place based social prescribing projects for West Suffolk!

Lizzi.Cocker@WestSuffolk.gov.uk

Any Questions?

www.onehaverhill.co.uk/lifelink

Which came first?

Amanda Green

I, and those around me, must

learn to live alongside my symptoms!

Recovery means

building a meaningful

and satisfying life

whether or not I have

on-going symptoms of

mental illness

a) Do we reduce symptoms before we start to do meaningful activity?

b) Does doing meaningful activity reduce symptoms?

NSFT Recovery Strategy: Priority Goal One

Recovery at the core of every conversation

I am useless,

worthless

I helped someone today at

work

I can’t do

anything

I’m studying for my MSc

I wish I was dead

I haven’t finished

everything I want to

do yet

To reduce my risk of suicide and self-harm

Support me to build a meaningful life and have reasons to live!

Question time

Break and refreshments

Workshops• Direct support

• Green therapy

• Arts, crafts and other interests

• Food and diet

• Sports and exercise

• Soul

Networks for Social Prescribing

Is this what public services do?

‘If you want to get somebody to do something, make it easy. If you want to get people to eat healthier foods, then put healthier foods in the cafeteria, and make them easier to find, and make them taste better. So in every meeting I say, “Make it easy.”

Richard Thaler, Economics, Nobel Laureate 2017

We All Need Networks

• There is support out there & it is getting easier to find

• Both for the individual in the community and for the staff member

• Just as important to connect people in organisations to each other

• Rich tapestry of experience & good practice to share both in communities and beyond geographical boundaries

• Asset based, “community up” approaches, link worker roles, are key and strength based conversations

We All Need Networks

• For example www.hertsdirect.org

• 1,600 contacts to HertsHelp per month

• In May 2017 triaged people to 140 different organisations

• Community Navigators provide HertsHelpinformation face to face to people who need more support/motivation (nudge?)

We All Need Networks

• For example www.connectwellessex.org.uk

• Over 170 organisations on website and 380 different activities to refer to

• Google Analytics - January 2016 to October 2017– 20,770 page views & 32,547 sessions & 2m56s average

session

• Trained over 500 Connect Well Champions in social prescribing and MECC to have a different conversation with people and lead empowered signposting

• Self-refer public launched on International Day of Happiness

Citizen

GP

Social Prescribing

Scheme

Social Prescribing

Scheme

Link Worker Role/Care Navigator

Co-production of a bespoke package of support and community links that the person wants

Social Care

Social Prescribing

Scheme

Other (voluntaries,

housing, Council,

pharmacy etc)

Embedding SP in the system…

‘No wrong door’

Social Prescribers are not Alone!• 1,300+ members

• 300+ projects

• NHSE support

• National Clinical Champion for Social Prescribing Dr Michael Dixon

• Regional leads East of England Tim and Siân

Parliamentary launch March 2016 (Dr Michael Dixon co-chair of NSPN left, Dr Marie Polley of Westminster University right, pictured with then Care Minister, Alistair Burt MP)

http://westminsterresearch.wmin.ac.uk/19629/

Evaluation Data

A review of the evidence assessing impact of social prescribing on healthcare demand and cost implications

Polley, M., Bertotti, M., Kimberlee, R., Pilkington, K., and Refsum, C.

http://westminsterresearch.wmin.ac.uk/19629/

• Share your evaluations to build the national SP evidence base

Nobel Prize material?

“I had a lady that was invited to a breast screening, who refused to go. So I offered to go with her, and waited with her in the waiting room. Now I know that next time she is invited she’ll go because she’ll know what to expect, because it’s not the frightening thing that she thought it was”. Community Navigator

“I picked her up and took her and on the way back she said ‘I never would have done that if you hadn’t taken me’….that exercise group had left her a leaflet, but she wasn’t motivated enough to do it by herself.” Community Navigator

East of England Regional Plan

• Help CCGs fill in NHSE questionnaires

• Two conferences per year (next one in June after international evaluation conference, Salford)

• Set up new Steering Group

• STP regional master class on Social Prescribing

• Helping network members support each other

• Share regional examples of schemes and good practice

Get in touch

• Tim Anfilogoff -Tim.Anfilogoff@hertsvalleysccg.nhs.uk

• Siân Brand –sianbrand@livingsafeandwell.co.uk

THANK YOU

Closing comments• Nigel Boldero, Public Governor, NSFT