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1 DUNDEE STRATEGIC SOCIAL PRESCRIBING GROUP Social Prescribing as a spectrum of approaches: mapping activity in Dundee April 2019 Dr. Phyllis Easton: Health Intelligence Manager, NHS Tayside Sheila Allan: Community Health Inequalities Manager, Dundee HSCP/ Neighbourhood Services

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Page 1: DUNDEE STRATEGIC SOCIAL PRESCRIBING GROUP Social ... · Dundee Strategic Social Prescribing Group (DSSPG) The group was established in May 2018 to respond to the recommendation from

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DUNDEE STRATEGIC SOCIAL PRESCRIBING GROUP

Social Prescribing as a spectrum of approaches: mapping

activity in Dundee

April 2019

Dr. Phyllis Easton: Health Intelligence Manager, NHS Tayside

Sheila Allan: Community Health Inequalities Manager, Dundee HSCP/ Neighbourhood Services

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Page Content

3 Executive summary

6 What is social prescribing?

6 National context

7 Supporting social prescribing approaches in Dundee: Strategic Social Prescribing Group

7 The survey

9 Results

18 Focus group summary

22 Summary and discussion

25 Recommendations and next steps

26 References

27 Dundee Strategic Social Prescribing Group membership

29 Appendix 1: the questionnaire

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THE SOCIAL PRESCRIBING APPROACH: A SURVEY TO MAP ACTIVITIES IN DUNDEE

EXECUTIVE SUMMARY

Background and context

Social prescribing has been on the agenda nationally across various divisions and topic areas in the

Scottish Government for a number of years and locally through a well-established process of system

wide working to help tackle health inequalities and promote mental wellbeing. Building system

capacity was a key aim of the Equally Well test site founded in 2009 and the approach has continued

through the work of the Health Inequalities Service aided by a range of partners and the prioritisation

of health inequalities and prevention approaches within the city.

Dundee Strategic Social Prescribing Group (DSSPG)

The group was established in May 2018 to respond to the recommendation from the independent

evaluation of the Sources of Support link worker service that there should be a specific plan for

developing social prescribing to prevent fragmentation and duplication of effort across existing

policies. DSSPG recognises that no single organisation owns social prescribing and the methodology

can apply to a specific service or as a range of approaches in different settings. It set out to develop a

framework to identify activity, duplication, gaps and opportunities, share best practice, and potentially

provide a tool for strategic commissioning partners and organisations wishing to develop their own

social prescribing schemes or activities.

What is social prescribing?

Social prescribing, also known as community connecting, navigating, or link working, is a term used to

describe a spectrum of approaches to support people to access services and activities that can help

deal with life circumstances and improve health and wellbeing. Various definitions exist reflecting that

social prescribing is not a treatment in itself but rather a social solution. A preventive approach

requires a broader spectrum of provision reaching people who may not be at the point of requiring or

perceiving themselves to require medical help.

The mapping exercise

In setting out to explore the local social prescribing landscape, DSSPG produced a Survey Monkey

questionnaire offering a description of approaches at different levels using a spectrum diagram:

1. Making

information

available

generally

2. Signposting/

provision of

specific

information

3. Supporting

contact with

services

4. Supported

access to services

5. Following up

and through

6. Dedicated

link worker

role

The survey explored who was doing what, where, with whom and why, and gave respondents the

opportunity to highlight barriers, challenges and ideas for development. The survey was distributed

widely and received 375 responses. Respondents were invited to leave contact details if they wished

to participate in a focus group, and three subsequently took place involving 14 participants. These

provided further insights on current activity, challenges and support required.

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Results

A summary of findings from the Survey Monkey questionnaire is provided below:

The survey reached a wide range of people across all sectors; the largest number of responses were from Dundee City Council employees (n=162) followed by NHST and Dundee HSCP

The majority of respondents (70.2%) were frontline staff

Respondents’ roles covered a wide range of topic areas. Almost one third focused on mental health. Physical health and community learning/ education were the focus of 1 in 5

Services were delivered at all levels; the most common response was at community level

Across the spectrum of approaches, the most common level reported was signposting and provision of specific information (84%)

12% of respondents identified themselves as not doing social prescribing at any level and were excluded from subsequent analyses

Of those who responded, over 1 on 5 reported spending more than 60% of their time on social prescribing. The majority worked this way with 10 people a week or less

Just over 1 in 10 described social prescribing as their main role whilst over half stated it was an agreed part of their role

Of those who responded, over ¾ felt there was a need for more social prescribing

The most common outcomes respondents were trying to achieve were improved physical and mental wellbeing, then increased knowledge of and access to services and activities

Over half (52.3%) of respondents had not attended any relevant training. Of those who had the most common were Health Inequalities and Prevention, and Poverty Sensitive Practice

A range of identified challenges were selected by respondents, the most common being lack of knowledge about services and activities and finding the time to do this

Challenges given in text responses were themed in the analysis as: service availability and delivery; the way that services are designed; client issues; access to information

Narrative in the “any other comments” section was themed as: knowledge/ access to information; client needs/ barriers; referral processes; service capacity; attitudes/stigma

These challenges were confirmed in the focus groups, which also added; lack of clarity on criteria for services; importance of stigma; potential for peer support and more informal support measures

There were mixed views in the focus groups on the usefulness of social prescribing as a term

Ideas for improvement included; developing a one stop portal for information; better use of community resources; and, provision of networking opportunities and forums for the wider social prescribing workforce

It should be noted that the mapping exercise could not gather data on every component of the

planned framework and issues around data collection were not explored. Work underway at a national

level to test a core minimum dataset for link worker services within general practice may provide some

useful insights.

Recommendations and next steps

This mapping exercise generated many interesting findings and evidenced lots of activity across the

spectrum of approaches. Some clear actions emerged including:

Progression of an information portal/ single point of access

Testing a learning network or forum

Learning from national work in terms of data collection

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Clarification of ongoing support required to build capacity for social prescribing including training and e-learning

In addition to the broad overarching aim of the framework reflected previously, the DSSPG has reflected on the data from the survey and focus groups and proposed that it also include the following:

Clear articulation of the differences between the service and approach

Assessment of the strategic agendas that either incorporate or reflect social prescribing already or which could be supported to do this e.g distress, risk, personalisation, offending, recovery, procurement

A reflection of the investment made currently in terms of link workers and to support the approach more widely e.g training

Articulation of the importance of prevention/ early intervention and the need to support this through a strong community infrastructure including volunteers

Where gaps exist and how these could be addressed

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THE SOCIAL PRESCRIBING APPROACH: A SURVEY TO MAP ACTIVITIES IN DUNDEE

What is social prescribing?

Social prescribing is most commonly set in the context of the NHS, specifically primary care. Brandling

and House describe it as being about “expanding the range of options available to GP and patient as

they grapple with a problem” while Skivington et al. describe social prescribing as a “collaborative

approach to improve inter-sectoral working between primary health care and community

organisations” and focus specifically on a links worker programme. However, in spite of the inter-

sectoral working definition, community organisations are seen as the recipients of service users who

experience one way referral through primary care. Similarly, others focus on specific programmes

(Bickerdike et al., Moffat et al.) or services (Carnes et al.) and view the social prescribing process as

originating from a medical consultation.

Kimberlee, in his paper on work within a CCG in England describes different models and seeks to find

a broader definition of social prescribing. He found that the term social prescribing was often used

interchangeably with social intervention, a term applied to a variety of different interventions aimed

at promoting wellbeing and/or health. Although Kimberlee gives examples of social prescribing

projects which operate independently of the GP, the process stems from a specific service.

In their essay, Brandling and House go on to suggest a definition of the options offered as those that

“make available new life opportunities,” a description that one might argue does not sit exclusively

within a medical model. Social prescribing is not a treatment in itself but rather a social solution.

Taking a preventive approach to health and wellbeing requires a broader spectrum of provision that

reaches people who may not be at the point of requiring or perceiving themselves to require medical

help.

National context

Health Scotland uses the following definition of social prescribing:

“Social prescribing is commonly used in primary care settings and provides non-medical options for

primary care staff to draw on to support their patients’ health and wellbeing, including their mental

health. Social prescribing is an approach used to support self-management. It is primarily used for

connecting people to non-medical sources of support or resources within their community. It can also

be used by professionals working in other services and enhances the holistic approaches to addressing

health, wellbeing and mental health problems.”

Health Scotland has supported developments around social prescribing for a number of years and

hosts a range of resources and case studies on its website including from the Sources of Support link

worker service in Dundee.

Social prescribing was sited originally in the mental health division of Health Scotland and the Scottish

Government and was picked up by the primary care division due to the connections with general

practice, particularly in terms of the efforts of the Deep End GPs in raising awareness of their increased

workload when supporting predominantly deprived patients. Subsequently, in 2013, a national

Community Link Worker Programme was initiated by the Scottish Government to test a link worker

approach in Deep End practices, which provided some resources for the service in Dundee. A

manifesto commitment in 2016 proposed to scale up this approach further to the tune of 250 link

workers across the country by the end of the current political term. Dundee was identified as an “early

adopter” and this greatly increased the number of nationally funded link workers at a local level

effectively providing resources to offer the service to all GP practices in the city with above average

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levels of deprived patients in their practice population. In April 2018, link workers within general

practice were included in the new GMS contract and funding for the programme transferred to

Primary Care Improvement Funds. The shape and scope of the local link worker service moving

forward is currently being negotiated.

Supporting social prescribing approaches in Dundee

Mapping the use of social prescribing approaches in Dundee builds on a process of system wide

working to help tackle health inequalities and promote mental wellbeing that has taken place over

the past ten years. The nationally supported Equally Well test site, which was established in one

deprived area in the city in 2009 and scaled up across all Community Regeneration Areas in 2013 was

the subject of a research study investigating whether a targeted intervention can result in changes to

services to better address the determinants of health inequalities and mental wellbeing. Results

indicated that a range of positive changes had taken place for staff working at all levels who were

involved in the test site including more recognition of the social determinants of poor health and

wellbeing, the need for compassionate and understanding responses for people experiencing

deprivation and inequalities, and increased awareness of other services, organisations and activities,

enabling them to signpost clients to alternative support. The study suggested that “a simple method

such as providing information about available opportunities, or signposting a person to sources of

support, and doing this in a manner that is respectful and empathetic can make the difference between

an individual remaining marginalised and excluded and developing connections that can help tackle

the causes or consequence of their wellbeing status.”

Evidence from the study suggested that one in every two stakeholders changed the way they delivered

their service as a result of involvement in the test site and that for many this included incorporating a

wellbeing and signposting component. The test site activities that were stated as being helpful in

supporting staff with this “social prescribing” role included the local health and wellbeing networks,

logic model events, community engagement, training and awareness sessions and the establishment

of the My Wellbeing web pages.

Dundee Strategic Social Prescribing Group

Social prescribing as an approach and service is reflected across a number of strategies and plans at a

local and national level. Dundee Strategic Social Prescribing Group was established to develop a

framework for the city picking up on the recommendation from the independent evaluation of the

Sources of Support link worker service in GP practices that there should be “a specific plan for

developing social prescribing to prevent fragmentation and duplication of effort across existing

policies” and “a plan developed with regard to the local strategic priorities and the National Link

Workers programme.”

The survey

In setting out to explore what the local situation is in terms of understanding and participating in social

prescribing activity, we offered a description of social prescribing approaches that can connect people

with options to improve health and wellbeing whether a problem has been diagnosed or not.

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The survey described here aimed to map current and planned activities taking place in Dundee that

use these social prescribing approaches to link people with services to improve their wellbeing and

social circumstances and to identify any challenges or issues that exist.

The survey was distributed through a Survey Monkey link using a number of networks and emailing

lists including for NHS Tayside and Dundee City Council employees, Dundee HSCP cascade system,

Third Sector organisations, local health and wellbeing networks, and commissioned services.

The following introduction was included at the beginning of the survey to set the scene for participants

and highlight the broad range of activities that make up a social prescribing approach.

Introduction

Social prescribing, also known as community connecting, navigating, or link working, is a term used to

describe a spectrum of approaches to support people to access services and activities that can help

them to deal with their life circumstances and improve their health and wellbeing. This can range from

giving information or simple signposting at one end of the spectrum to supported access and

dedicated link workers at the other. You may not classify yourself as a social prescriber but every

frontline member of staff can adopt these approaches to some extent, be it an implicit or explicit part

of your job. This questionnaire is relevant for you if you think you are carrying out this type of work

already, or would like to but feel unable to at the moment.

How does it work?

The diagram below shows that social prescribing approaches can work at various levels for different

types of people and client groups. It can be used to maintain positive health and wellbeing, prevent

deterioration in life circumstance for those who are at risk, and support recovery for people with

significant needs and challenges.

1. Making

information

available

generally

2. Signposting/

provision of

specific

information

3. Supporting

contact with

services

4. Supported

access to

services

5. Following up

and through

6. Dedicated

link worker role

Level descriptor:

1. Making information available generally (leaflets, posters, telephone numbers, website

addresses e.g. on display boards or at reception desk)

2. Signposting and providing information to individuals directly

3. Supporting individuals to make contact with services e.g. help setting appointments, making

phone calls, filling out forms

4. Supported access e.g. going along to a service or activity with the individual, if necessary for

them to engage

5. Following up and through (finding out whether the individual accessed the service, what was

the outcome, do they need help with anything else?)

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6. Link worker role where your job is to support clients to identify their needs and access the

services required to help

The survey questions are included as an appendix at the end of this report.

Focus groups

Respondents were invited to leave their contact details if they were willing to participate in a follow

up discussion. Three focus groups were convened after the survey closed. These provided further

insight to attitudes towards social prescribing and additional comments on the challenges and what

was needed to support future activity.

Results

Total responses

A total of 375 responded to the questionnaire. The largest number of responses came from Dundee

City Council (N=162), followed by NHS Tayside (N=66) and Dundee Health and Social Care

Partnership (N=60). Smaller numbers of respondents worked in other organisations listed in the

chart below.

Chart 1: Organisations where respondents work (N=375)

Role of respondents

Respondents were asked to select from a range of options what type of role they fulfilled in their

employment. A considerable proportion (70.2%) provided a frontline service. Proportions are shown

in Chart 2 below. Six people did not respond to this question.

0.5%

0.8%

0.8%

1.6%

2.4%

10.9%

11.5%

16.0%

17.6%

43.2%

Tayside Fire and Rescue

Police Scotland

Faith based organisation

Private sector

Other

L & C Dundee

Third Sector

Dundee HSCP

NHST

DCC

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Chart 2: Job role of respondents (N=369)

Focus of role

Respondents were asked what the focus of their role was. Almost one third (30.4%) of those who

responded focused on mental health (Table 1). Physical health and community learning/education

were both reported as the focus for 1 in 5 of the respondents. Respondents could tick more than

one option so totals are greater than 100%. ‘Other’ included Child or Adult Protection (10), Children

and Families (8), Information/Library Services (7) and Older People (4). Three people did not answer

this question.

Table 1: Focus of respondents’ roles (N=372)

Focus No. %

Mental health 113 30.4%

Physical health 77 20.7%

Community learning/ education 72 19.4%

Housing/ homelessness 48 12.9%

Learning difficulties/ disabilities 47 12.6%

Cross cutting/ multi-disciplinary 46 12.4%

Employability 43 11.6%

Other 42 11.3%

Community safety/ criminal justice 36 9.7%

Carers 34 9.1%

Substance misuse 32 8.6%

Volunteering 26 7.0%

Income maximisation 24 6.5%

Regeneration/ community planning 18 4.8%

Environment/ green space 15 4.0%

Frontline service , 70.2%

Back-of-house service, 2.4%

Service manager,

15.2%

Volunteer, 1.6%

Strategic, 5.4% Other, 5.2%

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Although, not surprisingly, of those who reported a focus on mental health, over half (58%) worked

in NHS Tayside or Dundee Health and Social Care Partnership. The remainder came from a range of

organisations including Dundee City Council, Leisure and Culture Dundee, Police Scotland and the

Third Sector. Responses to the question about which team participants were located in suggested

that many people who do not work in traditional mental health roles recognise the contribution

their work makes to the mental health and wellbeing of the population groups they work with.

Teams covered a wide range of areas such as adult learning, community justice, housing and

homelessness, leisure and sport, and library services. Fewer respondents reported a focus on

physical health and of those almost two thirds (64%) worked in health and social care. However, 18%

worked in Leisure and Culture and 8% in the third sector.

Level of service delivery

When asked about the level that their service was delivered at, the most common response was at

community level (42.8%). Respondents could select a maximum of 3 options and reported a range of

types of service as illustrated in Chart 3. Six people did not answer this question.

Chart 3: Level of service delivery (N=369)

Only 92 people indicated sub group categories. These covered:

LTC/ disabilities/specific condition (13); Children and families (10); Older people (9);

Unemployed/unfit to work/ low income (8); Young people (7); CJ/ offenders (7); Learning

disabilities (6); Care leavers/ carer (6). Small numbers reported complex needs, refugees/ BME,

tenant, domestic abuse and ‘other’ settings mentioned were: GP Practice, acute, schools, residential

care homes, own home.

3.0%

4.9%

19.2%

28.5%

29.0%

34.4%

42.8%

Other

Crisis level

Individual short term

Sub-group level

Population level

Individual intensive

Community level

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Level of social prescribing

Respondents were asked about the level of delivery within the social prescribing spectrum

illustrated at the start of the survey. Forty five people (12.1%) stated that they provided none of the

options and have been excluded from the chart below and from subsequent questions regarding

social prescribing activity. Results show that over 8 out of 10 people reported that they provided

information and signposting. Chart 4 shows that there is not a diminishing amount of social

prescribing as the intensity increases along the spectrum. As expected, the lowest response rate was

for supported access – buddying, hand-holding, advocacy, providing moral support etc. This has

already been identified as a gap, although it should be noted that over one third of staff do provide

this level of social prescribing support. Respondents could tick more than one option so totals are

greater than 100%, and two people did not answer this question

Chart 4: Levels of social prescribing reported by respondents (N=328)

Forty one respondents reported that they had a dedicated link worker role. It would appear that this

included many who were not named specifically social prescribing link workers but fulfilled that role

between services for the people they worked with. This was borne out over the next few questions.

Proportion of time

Respondents were asked to estimate the proportion of their time that was spent on social

prescribing activity. Three out of ten (30.4%) respondents either skipped this question or were

excluded because of having reported doing no social prescribing activity. Reported proportions are

shown below (Chart 5). Over 1 in 5 spent more than 60% of their time on social prescribing activity.

Of those spending 81%+ of their time in social prescribing activity, 25 reported that they were

dedicated link workers and 10 were not. This represents 6 out of 10 of those who reported being

dedicated link workers stating that they spend 81%+ of their time in social prescribing activity.

71.2%

84.0%

57.7%

41.4% 43.9%

12.6%

0%

20%

40%

60%

80%

100%

Makinginformation

availablegenerally

Signposting andspecific

information toindividuals

Support tocontact

services, makeappointments

Supportingaccess if

needed toengage

Following upand throughafter contactwith service

Dedicated linkworker role

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Chart 5: Proportion of time spent doing social prescribing activity (N=261)

Number of people

The number of people that respondents carried out social prescribing activity with varied across the

categories offered. Three out of ten (30.7%) either skipped this question or were excluded because

of their previous response of no social prescribing activity. Of the remainder, the majority worked

with 10 or fewer people over a week with smaller proportions working with greater numbers (Chart

6). Of those reporting that they worked with more than 20 people in a week, 7 had described

themselves as dedicated link workers.

Chart 6: No. of people receiving social prescribing activity over the course of a week (N=260)

Social prescribing in relation to role

Respondents were given three options to describe how social prescribing related to their role.

Almost one third (32%) either skipped this question or were excluded because of their previous

answer of no social prescribing activity. Just over 1 in 10 described social prescribing as their main

0 -20%, 35.2%

21 – 40%, 19.9%

41 – 60%, 18.8%

61 – 80%, 12.6%

81+ %, 9.6%

0-10, 61.1%

11-20, 21.5%

21-30, 6.2%

More than 30, 11.2%

, 0

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role while over half stated that it was an agreed part of their role (Chart 7). Of the 41 reported

dedicated link workers, 14 (34.1%) described social prescribing as their main role and 19 (46.3%) as

an agreed part of their role. Those who reported having added it to their role informally came from a

wide range of teams and provided support from across the spectrum.

Chart 7: Social prescribing in relation to role (N=255)

Current level of social prescribing

Respondents were asked if the current level of social prescribing should change. Over three quarters

of those responding thought that there should be more social prescribing (Chart 8). Only two people

thought that there should be less, and 90 people (24%) skipped the question. Forty four percent of

those who reported they undertook no social prescribing activity thought that there should be more

social prescribing.

Chart 8: Suggested changes to current level of social prescribing (N=285)

Agreed part of role, 58.8%

Added to my role informally,

29.8%

Main role, 11.4%

More social prescribing,

77.2%

Less social prescribing,

0.7%

About the same amount of

social prescribing,

22.1%

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Outcomes for individuals/families through social prescribing activity

Respondents were given a range of outcomes from which to select those relevant to their aims in

carrying out social prescribing activity. Table 2 shows the results. More than one box could be ticked

so numbers add to more than the total responses. One quarter (24.8%) did not respond to this

question.

Table 2: Outcomes aimed for through social prescribing (N=282)

Outcomes aimed for No. %

Improving physical and mental health and wellbeing 221 78.4%

Increasing knowledge of services and activities 209 74.1%

Increasing access to services and activities 211 74.8%

Improving life circumstances/ income levels 176 62.4%

Increasing social networks and connections 176 62.4%

Early intervention/ preventing harm 153 54.3%

Decreased reliance on your service 108 38.3%

Of those who aimed for a decreased reliance on their service approximately 4 out of 10 (41.7%)

came from health focused organisations and a similar proportion (39.8%) from Dundee City Council.

Training attended

Respondents were asked about training courses attended. Over half (52.3%) did not report having

attended any training. The remaining 179 attended 565 courses shown in Table 3 below. Note that

the percentages shown in this table are of the total responses to indicate the level of training

attended among all respondents to the survey.

Table 3: Training courses attended

Training course No. % of total

respondents

Health Inequalities and Prevention training 98 26.1%

Poverty Sensitive Practice 84 22.4%

Scotland’s Mental Health First Aid 81 21.6%

Substance Use, Stigma and Supporting Recovery 72 19.2%

Assist 69 18.4%

Mind Yer Heid Plus 49 13.1%

Sage and Thyme 39 10.4%

Safetalk 26 6.9%

Other 47 12.5%

‘Other’ included several who had attended training specific to conditions such as Alzheimers and

autism, and others who had received health promotion or behaviour change training.

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Challenges in providing social prescribing activity

Respondents reported facing a range of challenges selected from options offered. One third (33.3%)

skipped this question or were excluded because they reported that they did not carry out social

prescribing activity. Table 4 below shows the responses from the remaining two thirds. Respondents

could tick more than one option so numbers add up to more than the total.

Table 4: Challenges faced by respondents in carrying out social prescribing activity (N=250)

Challenge No. %

Lack of knowledge about services and activities 106 42.4%

Finding the time to do this 81 32.4%

The services or activities that would help the individual do not exist 79 31.6%

The individual does not qualify for services or activities that could help 59 23.6%

Having the skills or confidence to do this 35 14.0%

Having permission to undertake a social prescribing role 20 8.0%

I don’t think this should be part of my role 6 2.4%

Other (please specify) 45 18.0%

‘Other’ included some additional challenges or issues that had been experienced by respondents.

Mental health support was highlighted as being difficult to access, capacity or resources within

services was seen as an issue, as was keeping up to date with which services or activities were

available. Sustaining services that use volunteers was highlighted as challenging and concerns were

expressed about being able to guarantee that appropriate support would be received for the

individual.

Respondents were invited to add comments that highlighted any other particular challenges or

issues. Several comments were also added at the end of the questionnaire. These can be categorised

into three groups:

a. Service availability, design and delivery

b. Client issues/barriers

c. Access to information/knowledge of services

The following are typical quotes:

Service availability, design and delivery

“I think there needs to be more accessible social activities for older people and not just daycare/lunch

clubs and there needs to be more funding put into dedicated transport groups as this is a big barrier

to older people accessing services.”

“More specialist long-term services available for people with severe psychiatric disorders such as

schizophrenia or borderline personality disorder.”

“It would be useful to have link workers to assist housebound and lonely elderly individuals”

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The need for further collaboration or support, including increased capacity for the future was

expressed by several respondents:

“I would like to engage more closely with GP services. Currently we do not get GP referrals into our

service directly – this is most likely because they are unaware of what services we have on offer”

“GPs should be one of the first group to recognise how important social networks are and work with partners to learn what is going on in communities which may help their patients. From experience some GP's would gladly hand out information but it is difficult to get through the practice manger as social prescribing not always recognised as 'treatment'.” “I feel that the social prescribing role within my post, whilst acknowledged by management is not valued by them.” “Potential in secondary care .......” “As well as prescribing/signposting to specific existing services I think it's also important we work together to build the capacity of informal community supports otherwise we are just filling up groups and creating more demand without helping develop resources.” The need to be referred through a GP was seen as a challenge:

“... cannot access social prescribing directly - has to currently rely on clients personal motivation to

attend a GP to be referred to the social prescribing services.”

And others expressed a need to provide social prescribing activity outwith the medical context:

“I feel more social prescribing is required but in a more informal manner, in the community and not necessarily provided by services. A good opportunity to consider Peer roles in this capacity?”

There was support for what was viewed as the social prescribing model rather than social

prescribing activity:

“I personally feel this is an excellent model for supporting people to engage with other supports and services as often sign-posting is not adequate and the individual requires a worker to accompany them along to appointments in order to reduce that initial barrier and encourage engagement” “I do not think of providing information through leaflets and signage etc as part of Social Prescribing, even the aim is to increase physical activity and active travel.”

Some comments supported the idea of a preventive rather than reactive approach:

“I often feel that the service user would have benefited from social prescribing at an earlier stage and

that by the time I engage with them, their mental health issues have progressed to a point that they

are intimidated by the thought of mixing with others”

Client issues/barriers

“Trying to get a person’s benefits up and running when they come out of prison.... lack the needed

skills to make a claim e.g. confidence, using a computer and phone systems ........ stigma with some

agencies around offenders”

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“Mental health issues, substance misuse, domestic abuse, trauma which can lead to a lack of

motivation/engagement from clients supported to address these entrenched issues”

“Difficult to social prescribe for families who have no recourse to public funds.”

Access to information/knowledge of services

“I am very keen to be connected through the social prescribing model - we deliver a range of services which may not be widely known about and I would very much like to have better connections with GPs who may be the only health professional that an individual sees.” Knowing what is available was mentioned by several people, highlighting the challenges of

overcoming that:

“Information on activities, groups etc available in Dundee are not held centrally in one easy to access

place.”

ALISS was mentioned often through both additional comments in the survey and in the focus groups.

It was commonly viewed as potentially a good resource but not populated with enough information

to be useful.

Focus Group summary

In addition to the on-line survey, focus group sessions were offered to all respondents who had

indicated interest in having further discussions about their social prescribing role and had left their

contact details when completing the questionnaire. Of the 88 respondents who left details, 19

attended 3 focus group sessions in January and February 2019. Focus group participants came from

a wide range of background and services including the Third Sector, Health and Social Care, the

Council, and acute care.

There was a semi-structured format for the discussions covering the following key points:

1. Setting the context: this involved the facilitator giving a summary of the purpose of the

Strategic Social Prescribing Group, the aims of the mapping exercise and the aspirations for

the social prescribing framework that the findings of the survey will influence.

2. Introductions: participants introduced themselves and provided an example of how they

used social prescribing approaches currently. This found that many participants were

signposting their clients to other services and activities whilst others were offering support

to set up contact with and access services. A few focus group participants were providing a

dedicated link worker service and one participant did no social prescribing but passed on

clients to colleagues who could.

3. Exploring terminology: participants were asked if they considered this type of activity as

social prescribing at the time and whether it was a helpful term or not, and there were

different views around this. Many had no issue with the term and felt that it lent weight to

the validity of the approach as it could be perceived as having a medical or clinical value and

could support compliance.

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“Prescribing can conjure up images of doctors.”

“Only heard the term when the Link Workers went into the GP practices, so feel it has a

medical identity.”

“The term works well from a compliance perspective, people are more likely to comply when

the term is used.”

Others perceived the term detrimentally and felt that frontline staff did not understand

what it meant for them or their clients.

“A GP recently mentioned social prescribing, but we have found that there is not a broad

knowledge across practices or GPs”

“I would call myself a social prescriber through what I do within my role but feel that I have

to explain the term to people as most individuals don’t understand what it means”

Some felt that they had been using these types of approaches for a long time but had not

called it social prescribing.

“We have been signposting people for years and found it a successful approach.”

“...... roles involve support and signposting. It is needs based and provides a person centred

approach.”

“..... signposting is a day to day part of the role and we connect people with many different

services”

“Never knew the term until recently”

The spectrum diagram was seen by all as a helpful illustration of what is meant by social

prescribing approaches.

“It’s a good way of breaking down the different elements to social prescribing.”

One participant felt that there should be a reflection of the community activities that

formulate part of the social prescribing pathway, that is, those activities that people signpost

to.

4. A summary of what the survey found re. the challenges when adopting a social prescribing

role: the facilitator laid out the themes that free text responses had been categorised into

from the on-line survey and asked if these resonated with the focus group participants and

whether anything was missing.

a. Service availability, design and delivery

b. Client issues/ barriers

c. Access to information/ knowledge of services

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All participants felt that these themes were important and relevant. In relation to theme a)

discussions took place on factors such as waiting times and lists, bureaucracy, lack of staff

and quality of staff, and practical barriers to access such as transport, all of which were seen

to be important.

“The people that [we] visit would still have some accessibility issues .... often isolated with

mobility issues. We try to bridge situations like this with befrienders, but age is a continual

barrier and we frequently find that older people don’t use the internet.”

“.... systems that do not communicate with each other which means you face bureaucracy in trying to access information and face waiting for responses........ There is a lack of joined up thinking and transport is also another issue.” “Waiting lists are too long, people feel they are not supported as they cannot access services

and this then leaves us .... questioning which are the best services to signpost into.”

“We need more staff in services ......

“The quality of staff is more important, we need staff with the right skills.”

“I would like to be able to refer directly into SOS, currently having to refer clients back to

their GP for a referral to a link worker”

In b) there was general recognition that more vulnerable people often required support to

access services and that for some this required being accompanied by another person to

support engagement. Focus group participants reflected that there were too few services

that could provide this kind of support and/or potentially a lack of awareness (from them

and others more broadly) of the services that do. There was a comment that more

vulnerable people also need support to participate in groups, not only to get there. The fact

that some people are housebound was raised as an issue.

“..... some services do not advertise who can attend their service, who matches their criteria.

This can be an issue for individuals as they are left guessing or won’t engage as they perceive

that they will not be allowed to access that support.”

“... we can accompany a person to the first session of an activity or group but don’t have the

capacity to maintain that support level to continue attending meetings with them. This is a

bigger issue when a person has dementia and may not remember everything about the

previous session.”

Theme c) inspired most discussion and debate in the focus groups. Participants shared

frustrations at having to investigate regularly what services and activities are out there and a

lack of a single platform that enabled them to do this effectively. There was differing

awareness of local groups and organisations and those who worked at a city-wide or

regional level stated that it was impossible for them to keep up to date with the service

landscape. Many participants felt that they had built their own knowledge base through

networking or using trusted services previously, which they then relied on for their clients.

Networking was seen as a useful tool for learning about other services and some

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participants were in a position to do this more than others. Lower level community

based/led activities were seen as hugely beneficial but it was acknowledged that these often

sit below the radar in terms of an electronic presence and that awareness of them therefore

can be limited.

“.... there are free bus tickets available to people receiving cancer treatments but many people do not know they are available to them” “Individuals don’t necessarily know what services they will need or where to find them until their circumstances change and they actually need them”

5. Anything missing? A couple of participants mentioned a lack of clarity in how services and

activities are promoted meaning that people can be unsure of whether they qualify or can

attend. In addition, the issue of stigma came up and whether people may classify themselves

as someone in need of a particular service or whether they would feel comfortable

attending a specific group. Peer support was mentioned on a couple of occasions as well as

the benefits of using group or service participants as assets when promoting or delivering

activities.

“There are a lot of people within communities who want to help but they would not see

themselves as a social prescriber”

6. Ideas and solutions

- What would help improve the way that services work in relation to the needs of your

clients?

- What would help improve the ability of your clients to access services?

- What would help improve access to information/ your knowledge of services and

activities?

Following on from the above, discussions around what would help people in their social

prescribing role focused on a number of key areas. These included the development of a

one-stop portal for electronic information; an on-line resource that held information about

all services, organisations, groups and activities in Dundee including those that are very local

and low level. Some participants shared examples of where they searched already or what

they knew was available such as Aliss, the Directory of Local Organisations, My Wellbeing,

My Life and various websites. Participants reflected that they often resorted to using Google

and found this generally quite helpful. Others picked up the phone to ask someone they

thought might be able to help. Specific leaflets such as DD1 were mentioned as useful

particularly to give to clients to take away. Other ideas included an on-line forum or blog,

telephone information or helpline, or all group emails when someone was looking for

information about a service. It was suggested that quality assurance could be addressed

through a “Trusted Trader” approach.

“There is an awareness of services though [we] rely on publications like in Your Neighbourhood”

“... the Dundee Drop In leaflet”

“We don’t know everything that is out there so it’s good practice to share tips and ideas.”

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“There is a Directory of Organisations which is available on the Dundee City Council Website,

but it is only as good as the information that people provide us with regarding their services.”

“ALISS is a good tool and would improve if services put their details into the database.”

Using community networks and local people themselves was spoken about, either as

information sources or to provide community transport and/or to accompany people to

groups or activities. Bureaucracy and accountability was seen as a barrier to this type of

approach.

All focus groups raised the issue of networking opportunities and forums where staff could

share information about what they provide and hear about what other services are out

there. There was some awareness of existing local opportunities to do this such as Health

and Wellbeing Networks which those who attended found useful. To a greater or lesser

extent there was an appetite for some sort of social prescribing forum or network, and

potentially a range of events or workshops.

“We could do with a focus group every so often just to network and find out more about groups, and also to support each other in the type of social prescribing work we are doing with individuals”

Ideas included a type of “trade show” for local services and/ or a Dragon’s Den pitch where

services were given one minute to share their wares. It was acknowledged that this would

require leadership and resourcing. Many of those present felt that they would make it a

priority to attend if these kinds of opportunities were available whilst others would struggle

to make themselves available or would require a Tayside wide perspective.

7. Thanks and close

Summary and discussion

This survey attracted a considerable number of respondents from a wide range of organisations and

working across a variety of areas and population sub-groups within their role and remit. The survey

provided a snapshot of activity taking place in Dundee across the spectrum of social prescribing

approaches identified by the Strategic Social Prescribing Group and various proportions of

respondents reported participating in the individual activities across the whole spectrum. It was

anticipated that there would be a reducing gradient of activity reported as the spectrum moved

from basic provision of information towards a dedicated link worker role. However, this was not the

case and many staff were offering support at the more intensive levels of the spectrum, and at more

than one level, depending on the needs of their clients. Also, the numbers of people reporting that

they fulfilled a link worker role was greater than expected. However, this would appear to reflect

that people carry out that role in areas other than specific social prescribing services and from their

responses to other questions suggest that their activities sit within the social prescribing approach

although they may not be identified as such. Just over 1 in 10 of those who reported taking part in

social prescribing activity did so as their main role with over half reporting the activity as an agreed

part of their role and almost one third having added it to their role informally. When this is

considered alongside three quarters of the respondents indicating that they thought there should be

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more social prescribing, it would seem that for a considerable proportion it is included in their role

either formally or informally, and its value is recognised by the wider group of participants in the

survey.

In general, those respondents who reported using social prescribing approaches as part of their role

recognised the benefits and impact of this across a range of stated outcomes not necessarily related

to the primary purpose of their service or role.

Overall, over half of the respondents had not attended training courses relevant to population

groups likely to benefit from social prescribing and this may be an opportunity to provide support

through training to people who, through their participation in the survey, have expressed an interest

in social prescribing.

Many challenges in delivering social prescribing activity were reported in the survey and these were

borne out and expanded during the focus group discussions. Lack of knowledge of services and time

constraints were most commonly reported as was the lack of existence of appropriate services.

However, the latter may have been conflated with the lack of knowledge of these services. The

qualitative data gathered allowed a more detailed discussion of what the main challenges are and

what suggestions there were to promote the adoption of a social prescribing approach.

As with all surveys, there are limitations to the findings. Participants are self selected and their

responses self reported. Those with a particular interest in the survey topic are more likely to

respond and more likely to have particularly positive or negative opinions. However, in this case, in

setting out to explore the current situation in terms of people taking a social prescribing approach, it

was appropriate to hear from people with an interest in the subject so that we could find out about

their experiences and inform any potential development of the approach and activity. It was of

interest to see that almost one quarter had added social prescribing to their role informally and to

note that over 4 out of 10 of those who currently did not carry out social prescribing activity thought

that there should be more social prescribing. The qualitative data from both the survey and the

follow up focus groups allowed a greater understanding of people’s experiences, issues and

potential solutions.

The Dundee Strategic Social Prescribing Group recognises that no single organisation owns social

prescribing and that the methodology can apply to a specific service or as a range of approaches in

numerous settings and with different client groups. As stated above, the findings from the survey

and focus groups seem to bear out the fact that social prescribing (whether it is recognised as or

called this or not) is indeed happening in a number of ways in Dundee. The Strategic Group was clear

that its work will not result in a new strategy; instead, the aspiration is that the proposed framework

for social prescribing will reflect current activity, identify duplication, gaps and opportunities for

expansion or collaboration, share tools and best practice in terms of data collection and referral

pathways, and potentially provide a tool for strategic commissioning partners and organisations

wishing to develop their own social prescribing schemes or activities. In addition to the quantitative

findings reflected above, qualitative data from the survey and focus groups went some way to

gathering information that can at least in part begin to answer some of these questions and which

can start to shape the development of a partnership framework.

This investigation into social prescribing approaches aimed to identify whether duplication was

happening although this may be difficult to do through a survey and focus groups alone. Whilst it

could be surmised from the findings that lots of social prescribing activity is taking place in the city

and that some of this may be within the same services or communities with the same types of client

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groups, there is evidence to suggest that rather than duplicating effort this is providing a consistent

approach that helps identify unmet need with more vulnerable people. Respondents reflected that

they are having a range of conversations with local people and service users to identify what is going

on in a person’s life more broadly and to support them to find out about or access other services or

activities that can help. This holistic person-centred approach to working with people is unlikely to

result in too much support or unnecessary intervention. The resultant pathway and potential

outcome will be dependent on the unmet need identified, and participation in another service or

intervention is at the discretion of the person themselves.

The survey set out to identify gaps and opportunities for expansion. Free text comments in the

survey, and discussions in the focus groups, highlighted a number of areas where respondents felt

more could be done. Link workers for the elderly and in acute care settings was mentioned, further

support for those exiting prison was perceived as required, as well as more social activities and

opportunities for people in communities who are isolated. Suitable and affordable transport was

seen as a gap as was the lack of staff or volunteers who could provide direct support for more

vulnerable people to access and participate in groups. Although not a gap as such, some

respondents and participants in the focus groups felt that the quality of services in general could be

improved and that the attitude of some service providers when working with more vulnerable

people could be better. Stigma in general was mentioned on a number of occasions. Several

respondents mentioned bureaucracy and service criteria particularly in relation to trying to access

mental health support. This was seen by some as a false economy in that mental health may

deteriorate and more intensive support would be required further down the line. Arguably, the

importance of prevention and early intervention is well known and reflected in a number of key

strategic plans in the city. Both the City Plan and the Health and Social Care Partnership Strategic

Commissioning Plan reflect these approaches explicitly as priorities. It may be however that the

challenging financial climate for public services and the third sector is starting to affect the service

landscape and the bar is raised ever higher for qualification for services. Equally, there is enough

evidence to suggest that improved awareness of local opportunities may help link people with more

community-based activities that could for some prevent the need for mainstream services or act as

an adjunct to more formal support. A one-stop shop for access to information was perceived by

many as a desired and necessary development for the city.

As well as additional link workers and more social prescribing activity in general, alongside better

services and improved service landscape, some respondents thought that there should be

opportunities to learn from others adopting a social prescribing role. Focus groups participants in

particular thought that a learning network or forum would be helpful. The benefits of existing

forums were mentioned and the local Health and Wellbeing Networks in particular were perceived

as useful places to hear about and share service developments. A few focus group participants had

taken part in information sharing events and workshops and felt that opportunities such as these

were beneficial. For some, just the chance to network and talk to other service providers would be

enough, whereas others seemed to indicate that something more with perhaps a skills development

focus could help. Given this interest it may be worthwhile to consider testing a new forum with a

specific focus on supporting social prescribing and/or events or conferences once or twice a year.

How these would be resourced would have to be confirmed and it should be noted that not all

respondents would necessarily find it easy to commit time to attend.

Further, in terms of opportunities for expansion or collaboration, there seemed to be genuine

commitment to and interest in supporting communities to be part of the social prescribing

workforce. There was a general view in the focus groups and through some of the comments in the

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survey that informal support for people in their local communities was often the best solution. Using

local people as assets and avoiding medicalising or formalising support was mentioned in all focus

groups with examples of good practice given such as time-banking and community cafes. As well as

being supported to develop their own responses and run their own activities, some participants felt

that local people could be harnessed in promoting activities and supporting others to attend. This

“peer support” approach was seen to be effective in supporting the more vulnerable. In the absence

of this, some respondents in both the focus groups and survey felt that there should be more

“buddying” type posts, whether paid or unpaid.

The Strategic Social Prescribing Group aims to develop a framework that will share tools and best

practice in data collection and referral pathways for example. Whilst the investigation unearthed

some ideas around how to share best practice and inform referral pathways as mentioned above,

issues around data collection and other tools were not mentioned specifically by respondents except

perhaps in terms of building evidence of impact and efficacy to help justify and validate their social

prescribing role. This could be explored further in social prescribing learning networks or forums

should they be established. In addition, the siting of social prescribing link workers in general

practice as part of the new GMS contract and Primary Care Improvement Plans will provide

opportunities to share learning around this model across Tayside. This would link into the work

being supported by the Scottish Government and Health Scotland at a national level to test a core

minimum dataset with the “early adopters” including the Dundee Sources of Support service. It

would make sense to explore overlaps between the development of the social prescribing link

worker service in primary care in Tayside, the nationally supported developments, and the

overarching support for this approach more broadly across the wider public health workforce in

Dundee.

Lastly, one of the aims for the framework is that it could be used as a possible tool for strategic

commissioning partners wishing to develop their own social prescribing services or activities. In

order to do this, it is proposed that further consideration is given to assessing and analysing how

social prescribing as both a service and approach is integrated into existing plans for the city and

what else needs to happen to ensure that this is part of the fabric of how services are planned and

delivered in Dundee. The results of this survey begin to paint a picture of a workforce that is willing

and able to provide holistic support to their client groups and local people in general recognising the

benefits for individuals and services in doing so. More can be done to make this easier and more

efficient. Priorities suggested by these findings include ensuring management and strategic support

for this approach, the development of a one-stop portal to access information about services and

the establishment of learning networks as well as targeted support for some vulnerable groups that

could benefit from more intensive and tailored engagement.

Recommendations and next steps

A summary of the actions that emerged from the mapping exercise and subsequent discussions within

the Dundee Strategic Social Prescribing Group are summarised below:

Progression of an information portal/ single point of access

Testing a learning network or forum

Learning from national work in terms of data collection

Clarification of ongoing support required to build capacity for social prescribing including training and e-learning

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In addition to the overarching aim of the framework, the DSSPG recommended that it should also include:

Clear articulation of the differences between the service and approach

Assessment of the strategic agendas that either incorporate or reflect social prescribing already or which could be supported to do this e.g distress, risk, personalisation, offending, recovery, procurement

A reflection of the investment made currently in terms of link workers and to support the approach more widely e.g training

Articulation of the importance of prevention/ early intervention and the need to support this through a strong community infrastructure including volunteers

Where gaps exist and how these could be addressed This report will be shared widely with key partners and the above actions and recommendations agreed and taken forward as required.

References

Bickerdike L, Booth A, Wilson PM, Farley K, Wright K. Social prescribing: less rhetoric and more

reality. A systematic review of the evidence BMJ Open 2017; 7:e013384

Brandling J, House W. Social prescribing in general practice: adding meaning to medicine.

British Journal of General Practice 2009; 59(563): 454-456

Carnes D, Sohanpal R, Frostick C, Hull S. Mathur R, Gopalakrishnan N, Tong J, Hutt P, Berlotti

M. The impact of a social prescribing service on patients in primary care: a mixed methods

evaluation BMC Health Services Research 2017; 17: 835-843

Kimberlee R. What is social prescribing? Advances in Social Sciences Research Journal 2015;

2(1): 102-110.

Moffat S, Steer M, Lawson S, Penn L, O’Brien N. Link Worker social prescribing to improve

health and well-being for people with long-term conditions: qualitative study of service user

perceptions. BMJ Open 2017; 7: e015203

Skivington K, Smith M, Rui Chng R, Mackenzie M, Wyke S, Mercer SW. Delivering a primary

care-based social prescribing initiative: a qualitative study of the benefits and challenges.

British Journal of General Practice 2018; July: e487-e494

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Strategic Social Prescribing Group membership

The list below reflects members who have been active in attending meetings and also those on the

distribution network who receive documentation for information and comment.

Name Post Title Organisation

Sheila Allan Community Health Inequalities

Manager

Neighbourhood Services/ Dundee HSCP

Shona Hyman Senior Manager, Service

Development & Primary Care

Dundee H&SCP/ NHS Tayside

Craig Mason Senior Manager, Council Advice

Services

Dundee City Council, Corporate Services

Frank Weber GP Principal

Theresa Henry Sources of Support Team Leader Dundee H&SCP

Ailsa McAllister Senior Officer, Strategy,

Performance & Support Services

Dundee H&SCP

Christine

Lowden

Chief Executive Officer Dundee Voluntary Action

Karen Moir Senior Officer, Community Safety

& Justice

Dundee City Council

Allan Millar Employability Manager Dundee City Council, City Development

Alan Gibbon Senior Chaplain Spiritual Care, NHS Tayside

Mary Colvin Senior Health Improvement

Practitioner

Directorate of Public Health, NHS Tayside

Peter Allan Community Planning Manager Dundee City Council, Chief Executive’s

Dept.

Jim Fenton Housing Manager, Tenancy &

Estates

Dundee City Council, Neighbourhood

Services

Gwen Davidson ICJ Senior Manager Dundee H&SCP

Simon Brady Macmillan Development Officer Leisure and Culture Dundee

Eric Knox Chief Executive Officer Volunteer Dundee

Lynne Duncan Member Friend of Botanic Gardens

Grigor Grant Senior Health Practitioner Dundee City Council, Discover

Opportunities

Allison Fannin Planning and Development

Manager

Dundee H&SC Partnership

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Phyllis Easton Health Intelligence Manager Directorate of Public Health

Mike Andrews Resource Manager Dundee H&SC Partnership

Laura Menzies Senior Officer, Contract Services Dundee H&SC Partnership

Maureen

McGlone

Senior Officer, Contract Services Dundee H&SC Partnership

Michelle Young Equally Well Co-ordinator Dundee City Council, Neighbourhood

Services

Alison Anderson Greenspace Team Leader Dundee City Council, Neighbourhood

Services

Viola Marx Green Health Partnership co-

ordinator

Dundee City Council, Neighbourhood

Services

Distribution list

Arlene Mitchell Locality Manager Dundee H&SCP

Mark

McGilchrist

Senior research fellow Div. of Pop. Health Sciences

Glyn Lloyd Service Manager Dundee City Council, Children & Families

Frances Greig Manager, Learning and

Organisation Development

Dundee City Council, Corporate Services

Karen Gunn Manager, Discover Work Service Dundee City Council, Corporate Services

Lindsay

Cameron

Senior Welfare Rights Officer Dundee City Council, Corporate Services

Kenna Balion Welfare Right Officer Dundee City Council, Corporate Services

Lesley Howells Centre Head Maggie’s, Dundee

Nicola Steven Project Manager/ Practice

Facilitator

Dundee HSCP, NHS Tayside

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Appendix 1

This survey

This survey has been developed by Dundee Social Prescribing Group to map current and planned

activities and outcomes across the spectrum and identify any challenges or issues that exist. Findings

will help develop a framework that reflects current activity, shares best practice, identifies gaps and

opportunities, and provides a tool for those wishing to develop this way of working. Information

collected will be confidential and used only for the purposes of the mapping exercise. All data will be

anonymised and you will not be identifiable by the results.

1. Which organisation do you work within?

Dundee City Council

NHS Tayside

Dundee Health and Social Care Partnership

Leisure and Culture Dundee

Police Scotland

Tayside Fire and Rescue

Third Sector

Faith-based organisation

Private sector organisation

Other (please specify)

2. What specific team or section of this organisation do you work in?

Free text box

3. What is your role?

Please select one option which reflects your main area of responsibility.

I provide a frontline service which brings me into contact with people

I provide a back-of-house service

I manage a service

I volunteer

I work at a strategic level

Other (please specify)

4. The key focus of my role/ service is:

Please select a maximum of three options

Employability

Substance misuse

Community safety/ criminal justice

Income maximisation

Housing/ homelessness

Community learning/ education

Mental health

Physical health

Regeneration/ community planning

Environment/ green space

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Volunteering

Carers

Learning difficulties/ disabilities

Cross cutting/ multi-disciplinary

Other (please specify)

5. My service is delivered at:

Population level (universal service that everyone is entitled to)

Community level (within a designated geographic area)

Sub-group level (with a particular type of person e.g. parents, unemployed, older/ young

people, those with mental health issues, carers) Please state which (free text box).

Individual level/short term (one-off or limited contact)

Individual level/ intensive contact (case worker/ key worker, longer term regular contact)

Crisis level (emergency services e.g. A&E, Police)

Other (please specify)

6. The level that I deliver social prescribing is:

(Please tick all that apply)

Making information available generally (leaflets, posters, telephone numbers, website

addresses e.g. on display boards or at reception desk)

Signposting and providing specific information to individuals directly

Supporting individuals to make contact with services e.g. help setting appointments, making

phone calls, filling out forms

Supported access e.g. going along to a service or activity with the individual, if necessary for

them to engage

Following up and through (finding out whether the individual accessed the service, what was

the outcome, do they need help with anything else?)

I have a dedicated link worker role

None of the above (direct to question 13)

7. The proportion of my time that I spend doing this is approximately:

0 -20%

21 – 40%

41 – 60%

61 – 80%

81+ %

8. The number of people that I do this with over the course of a week is approximately:

0-10

11-20

21-30

More than 30

9. Social prescribing is:

My main role

An agreed part of my role

Something I have added to my role informally

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10. I think there is a need for:

More social prescribing

Less social prescribing

About the same amount of social prescribing

11. Outcomes for individuals

What are the outcomes you are aiming to achieve for individuals/ families through your

social prescribing activity? (Please tick all that apply)

Improving physical and mental health and wellbeing

Improving life circumstances/ income levels

Increasing knowledge of services and activities

Increasing access to services and activities

Increasing social networks and connections

Early intervention/ preventing harm

Decreased reliance on your service

12. I have attended the following training:

Health Inequalities and Prevention training

Poverty Sensitive Practice

Mind Yer Heid Plus

Substance Use, Stigma and Supporting Recovery

Assist

Safetalk

Sage and Thyme

Scotland’s Mental Health First Aid

Other (please specify)

13. The challenges that I face in being a social prescriber are:

I don’t think this should be part of my role

Finding the time to do this

Having the skills or confidence to do this

Lack of knowledge about services and activities

The services or activities that would help the individual do not exist

The individual does not qualify for services or activities that could help

Having permission to undertake a social prescribing role

Other (please specify)

14. Please use this space to reflect anything else you would like to say about your social

prescribing role, or lack of activity of this type, that has not been covered elsewhere. Please

include information about any social prescribing activities that you are planning.

15. The Social Prescribing Group would like to have more detailed discussions with staff

regarding their social prescribing activity and the results of this survey. If you wish to be

considered please leave your email address and telephone number below or contact

[email protected]