Mainstreaming of Social Prescribing in the NHS: opportunity or challenge for the sector

The NHS defines social prescribing as:

‘enabling all local agencies to refer people to a ‘social prescribing link worker’ to connect them into community-based support, building on what matters to the person as identified through shared decision making, personalised care and support planning, and making the most of community and informal support’.

The newly launched NHS Long Term Plan commits to embedding social prescribing link workers into the newly emerging Primary Care Networks (PCN’s) multi-disciplinary teams, using new national funding. Read my previous blog on the NHS Long Term Plan.

PCN’s will be established across England and are in effect local collaborative clusters of GP practices and multi-disciplinary health and care teams supporting populations of between 30-50,000.

They should be small enough to provide personal care valued by both patients and GPs, but large enough to have impact and economies of scale through better collaboration between practices and others in the local health and social care system. There will be the option to secure one link worker per PCN from July this year and this will increase in future years.

Perhaps the positive to take from this is that the move to incorporate a holistic personalised non-medical worker within the multi-disciplinary health and care teams with strong understanding and links into the VCSE at local level brings an opportunity to ensure that what may have been previously seen as ‘added value’ external 'fluffy' services are an important and vital part of the core provision of health and care locally.

It is also encouraging that something more than signposting people to services and support is required, particularly for those with multiple and complex issues. A link worker builds trust with individuals and works with them to identify what matters most to that individual,  taking a holistic approach based on the person’s priorities, and the wider determinants of health and,co-producing a personalised support plan and helping them put it into practice. 

Some may say that the voluntary sector has been doing this for years but it wasn’t perhaps called ‘social prescribing‘.

The role also includes capacity building and identifies drawing on and increasing the strengths and capacities of local communities, enabling local VCSE organisations and community groups to receive social prescribing referrals. Given that there is no resource attached to the role for investment in the VCSE it will be interesting to see how these new link workers can respond to this challenge. After all we need to remember that social prescribing cannot exist without the infrastructure of a strong and broad VCSE around it for link workers to refer to.

There is an opportunity and indeed encouragement from NHS England for the emerging PCN’s to build on what’s already there and potentially fund a local voluntary sector organisation to employ the link workers on behalf of the network but the contractual arrangement will be for local areas to decide.

However, there is a concern that local clinicians in PCN’s, who will be driving the recruitment of these new link workers, will not take account of the evidence base around the value of basing link workers in the VCSE and on building on existing well established ‘social prescribing’ schemes. They could recruit the new workers directly into the PCN practice team; creating a potential for the worker to be operating outside existing schemes which could provide the necessary understanding, knowledge and experience of managing such workers, in addition to enabling workers to link into the relationships that exist within the VCSE locally.

Clinical Commissioning Group leads locally have also been asked to pull together relevant stakeholders from across sectors including PCN leads to develop a local social prescribing shared plan. The shared plan should demonstrate how partners will build on existing local social prescribing connector schemes to avoid duplication and maximise impact and crucially ‘a commitment to provide shared local investment for the VCSE sector and community groups receiving social prescribing referrals.’

Although PCN’s are not mandated to work to this plan one would hope they would see the value in buying into it. A shared plan can provide economies of scale and flexibility beyond a lone link worker attached to a small cluster of practices.

North East Social Prescribing Network Conference

In March we held the first North East Social Prescribing Network Conference supported by NHS England, The National Lottery Community Fund and VONNE which was extremely well attended by a cross section of both commissioners and providers of social prescribing from across the NHS/ local authority and VCSE in the region.

It was clear the biggest impact on the day was hearing about the positive impact on individuals that five local social prescribing projects from across the region had.

The value of a link worker building trust and taking time with individuals, supporting them to tackle what mattered most to them including the social and financial issues impacting on their health and wellbeing, was clear. NHS England has set up an online learning platform to share the latest resources and you can access presentations from the conference. To join the platform, please contact england.socialprescribing@nhs.net.

This month we will start to see the development of shared social prescribing plans at local authority/clinical commissioning group level in response to the NHS Plan. Hopefully the value and impact of these local schemes and others like them will be recognised and built on within those plans and the VCSE partners delivering those projects will have a voice in shaping the plans.

I live in hope and as the North East Regional Social Prescribing Facilitator I am working hard along with the North East Regional Social Prescribing Steering Group to make this happen. 

Further reading: Chris Drinkwater, Emeritus Professor of Primary Care Development at Northumbria University, Social Prescribing (via the BMJ).

Jane Hartley
Health and Wellbeing Associate, VONNE

Jane.Hartley@vonne.org.uk