welcome and mind body... · 2018-03-26 · draft social prescribing plan on a page aim: to make...
TRANSCRIPT
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: [email protected]
https://www.westminster.ac.uk/social-prescribing-network
NHS England – Repository ContributionsEmail: [email protected]
East of England Social Prescribing Facilitators:Tim Anfilogoff email: [email protected]
Sian Bran email: [email protected]
Resources
Social Prescribing and Community Connectors in
Norfolk
Rob Cooper
Head of Integrated Commissioning
(Norfolk County Council and South Norfolk CCG)
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)
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 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!
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
Closing comments• Nigel Boldero, Public Governor, NSFT
