Tom Johnson & Nicola Kershaw July 2017 Social Prescribing Tom Johnson & Nicola Kershaw July 2017 We want to encourage a culture change in the way we support individuals, sparking a long term debate about the way in which we deal with increasing pressures and limited resources.

CHANGING NEEDS & FINANCE Social isolation and ill health in our communities across hertfordshire Rising demand in services due to people living longer with more complex needs Financial pressures, systems stretch to capacity and peoples needs changing. How can we build resilient communities who can support themselves despite that? 12m savings in hcc in 2017/18 Approximately 16% of Hertfordshire’s population are aged 65 years and over (173,915). It is predicted that this will significantly increase over the next 20 years showing an increase over more than 50% over the next 20 years. This suggests that there will be significant an increasing numbers of individuals using this service in the coming years. 13.1% of Hertfordshire’ older population is considered to be living in poverty. Districts with higher levels of deprivation are in Broxbourne, Hertsmere Stevenage, North Hertfordshire and Watford. Can’t attract and retain staff/social workers to the area. Waiting list are already very long and continuing to gro 318,000 people living with LTC – 30% have MH needs/ issues/ things

A COMMUNITY FIRST APPROACH How do my family & friends support me? How can the Community Support me? Neighbours, community groups? How can I get Specialist Support? Charities, job centre, support groups? How could technology, equipment and deliveries support me? HILS, Telecare? Do I need formal health and social care? Social Worker GP Nurse NEED 27% of GP appointments are inappropriate Social care is completely and utterly broken COST

Reporting and Evaluation Social Prescriber Referal made to the Link Mechanism for social welfare and other support by a health care professional Link Mechanism Undertake a brief assessment with participant and links them to groups and services Participation Participant joins a social participation group Impact Participant benefits from social connectedness, activity and service linkages Monitoring Where appropriate, link mechanism monitors changes in participant wellbeing Reporting and Evaluation Reporting back to referer and evaluating for funders

Social prescribing…. In action

Step 1: Find out what the problem really is I’ve done all I can clinically – but he still comes every month Since my brain injury my blood pressure has gone through the roof! And I’m anxious about meeting new people and I’m not sleeping Challenging conversations Knowing whats out there Training

STEP 2: MAKE THE REFERRAL

Step 3: Appropriate assessment Experienced and persistent Local knowledge Strengths based approach Face to face assessment Local knowledge Face to face Cool

Step 4: Participation & impact It’s great to meet people with lived experience – I feel connected and supported I have friends here who would know if I didn’t show up When I’m here I feel happy and involved I didn’t see anyone for weeks before I came here I feel confident to volunteer now Now I am happy!

Step 5: Monitoring & reporting 3rd Sector in Hertfordshire is great! 13,000 carers a year get support from Carers in Herts Hertswise supports at least 3,000 people a year £10m worth of service with 50 providers – plus 3,000 smaller groups The Community Wellbeing Commissioning team (CWB) manages contracts with over 50 providers, not including providers they sub-contract with. The total value we commission is c£10m, drawn from the Better Care Fund – a combined pot between Herts County Council and our two NHS Clinical Commissioning Group’s (CCGs). Services are contracted to provide a variety of primary, secondary and tertiary preventative outcomes, helping to avoid, reduce or delay the need for a person to use formal health and social care. Connect Hertfordshire, the county-wide VCS support and infrastructure service, estimate there to be 3,000 mainly small charities in Hertfordshire. There is lots of quality support in Hertfordshire which isn’t contracted or commissioned, provided by churches or local community groups. These groups usually rely on fundraised monies, and might find scaling up or working with your project difficult unless given proper time. The majority of voluntary organisations in Hertfordshire support their service using volunteers, but almost all have paid staff, with the usual professional support systems, organisational governance etc. Most are best described as charities, operating at full capacity or with waiting lists for services.

Any Questions?

RESOURCES FOR PROXIES… HertsHelp: 0300 123 4044 directory.hertfordshire.gov.uk