1. Social Prescribing in action in Hertfordshire
Hertfordshire Sports Development Conference
23rd November 2017
Ciceley Scarborough, Public Health

2. What is social prescribing?

3. Very simply put social prescribing is……..
Supporting people to benefit from non-medical activities that are recommended and could enhance your wellbeing & health………
You and your organisations are already providing these opportunities………

4. Social Prescribing on a page the Herts model

5. What is social prescribing…in words
Referral/signposting – GP, nurse, consultant, physio, social worker….
Link person/mechanism – co-produced support
The prescription: service/s and connections already in the community – just another way in
Key service (face to face): Hertfordshire Community Navigator Service (already in West, moving to the East)
Key service (not face-to-face)

6. Is Social Prescribing new?
Its not new! – the Community sector and social workers have always done this – but the system could be better connected
What is new in Herts is:
Central point of contact (HertsHelp)
Community navigator service extending from West Herts and other ‘Link workers’ (eg Age UK hospital discharge workers)
The NHS’s Sustainability & Transformation Plan (STP) is focusing on ramping up social prescribing

7. Two Key Principles for the NHS
People can receive social prescribing initiatives that include a range of free and paid for services. This is appropriate.
The NHS will need to invest in social prescribing schemes where the volume of activity originating from the NHS draws on substantial community sector capacity.
The view of NHS England

8. Why is Social Prescribing on the Agenda?

9. The NHS wants it done better…
“ We will work collaboratively with the voluntary sector and primary care to design a common approach to self-care and social prescribing, including how to make it systematic and equitable” (p45, Next Steps for the Five Year Forward View” + High Impact Action in GP5YFV)
Simon Stevens – Chief Exec of the NHS

10. Does Social Prescribing work?
Powerful case studies – clients report life changing outcomes
Proof of concept established
But lack of robust evidence so far
Impact on healthcare use reported in different parts of country
Public Health evidence briefing & recent NHS review:
While evidence is building, social prescribing schemes should be based on principles of good practice
We are working on this….

11. How does social prescribing work & how is it being developed?

12. How does it work? HertsHelp Offer
Web – Hertshelp.net
Text – HertsHelp to 81025 –
Skype - HertsHelp
Minicom on
Fax
Telephone or Text HertsHelp to 81025
Face to Face advice – arrange on
Advocacy – via professional referral
Communication Toolkit - BSL, Makaton, Braille Service

13. LIVE FROM 1 OCTOBER 2017
HertsHelp Integrated Hospital Discharge and Navigator Service
Watford General - Hospital Discharge & Navigator Service
covering Watford & 3Rivers
Team of 8
Lister Hospital – Hospital Discharge & Navigator Service covering
Stevenage & N Herts
Team of 8
Upper Lea Valley
Navigator Service
Team of 2
Stort Valley & Villages
Navigator Service
Team of 2
Hertsmere
Hospital Discharge & Navigator Service
Team of 4
St Albans
Hospital Discharge & Navigator Service
Team of 4
Dacorum
Hospital Discharge & Navigator Service
Team of 4
Lower Lea Valley
HD & Navigator Service
Team of 3
Welwyn GC & Hatfield
HD & Navigator Service
Team of 3
Princess Alexandra HD Service – Team of 2
Lot1 and 2 Sub contracts to 3 local providers for delivery.
Volunteer important throughout each sub-contract
Teams of 4 staff numbers to be decided HDS And Comm Navs
Community Navigator Scheme, April 2016 – Feb 2017
1,978 referrals
52% from GP surgeries
24% from Social Care
7% from Herts Help (ie needed face to face support)
Also: community sector, mental health services, neighbourhood policing, rapid response, housing, Community NHS Trust….
NB Navigator role on Multi-Specialty Teams
GPs, other Primary Care staff and Social Care
Teams will include Hospital Discharge Co-ordinators and Community Navigators and will work flexibly to meet needs.

14. Giving clinicians confidence to refer/signpost to a social prescription

15. 8 key ingredients for signposted activities in the Community Sector
A credible link to health & wellbeing
Easy to access – via Herts Help or directly
Appropriate insurance cover
Staff are appropriately & sufficiently trained
Evaluated or willing to start
If already evaluated, outcomes are positive
Affordable to participate in
Funded beyond the near future…

16. What Can social prescribing deliver?

17. 5 key targeted outcomes Improved Wellbeing (agreed tool: SWEMWEB)
Reduced Social Isolation (agreed tool: campaign to end loneliness tool)
Reduced future home care use (referrals from social care to navigators instead or as well)
Reduced hospital (re)admission & faster discharge from hospital
More appropriate use of primary care

18. What is Social Prescribing designed to do?
Making sense in a chaotic environment. People who come to NHS for ‘wrong’ social related reasons. People the NHS can’t help…
Example: Talking Therapies (IAPT) wasn’t working well for an individual (too chaotic). Community Navigator persisted: found debt, imminent eviction, not paying bills, benefits stopped…
Client: ‘Once the threat of eviction [was] removed…I felt a weight had lifted and I could now concentrate on me and on tackling the depression… I still feel that I have something to give and ultimately I want to get back into work and I would like to look at volunteering as a way of doing this…’’
20% GP face-to-face time spent on non-medical issues, 15% on welfare issues (Low Commission)
There is extensive social support in the community sector (12,000 groups on
HertsHelp provides expert first contact: referred on to 140 DIFFERENT organisations in May 2017
Many people/clinicians don’t know how to refer & signpost onto relevant community initiatives

19. Social Prescribing: to walk more
Judy B
“The walks help me to stay young – I am so much fitter now; I can walk faster than my son and even my grandchildren struggle to keep up!
As well as the health benefits I have met some lovely people. Many of the people you meet are so interesting to talk to and are all very different, from all walks of life.
I now meet up with some of the people I met on the walks and we do our own walks.”
Herts Health Walks

20. Social Prescribing: for weight loss Success is possible - Steve Atwell

21. Social prescribing to meet, cook, and eat – North Herts & East Herts“
“When you’re on your own it’s not worth turning on the oven”
“I don’t cook now as there’s no pleasure…it’s nice when you’ve got someone else enjoying what you made”
“After we’ve been down here, my husband comes to life. He says it reminds him of big family meals with all the kids – just like the old days”
“I need to take care of someone….coming here and making bread for everyone has made me feel quite emotional”

22. Social prescribing: arts on prescription for wellbeing
She felt that the project “gave me a reason to get out – that was really helpful”. It was “good to have a regular thing to go to [and] look forward to”. It helped her to get back into a routine for example returning to the gym.

23. Social Prescribing: Learning for wellbeing
Ian enrolled at New Leaf Wellbeing College having gone through a difficult personal situation where he felt he needed help to improve his mental wellbeing.
“I booked onto a number of courses offered by the college and found that the knowledge and practical skills I gained had a very positive impact on my mental outlook, helped in part by the compassion of the course tutors and their real sense of care.

24. Social Prescribing: reading for self help
Reading Well: books on prescription for long term conditions
Mood boosting books

25. re-hab session is NOT a social prescription
Physical Activity is key to social prescribing…everyone in this room knows the benefits of PA for health
But…with care around a clinical referral into physical activity, for example phase 4 cardiac
re-hab session is NOT a social prescription

26. So many more examples Including: Volunteering Befriending
Including:
Volunteering
Befriending

27. To conclude

28. Key Message – if nothing else remember just one thing!
Herts Help
County wide gateway to the wide range of services in the community sector
Branding to make it easier to find
If nothing else, make sure Herts Help know about what you offer, and has up to date details!

29. How to engage with Herts Help and let them know about your social prescription
If you want HH to know about your organisation you can:
HH -
Put your information on the Hertfordshire Directory Herts Help use this info to advise residents so if you’re on the Directory they’ll find you
Make sure your information is regularly updated on the Hertfordshire Directory
Phone HH and ask them to help you get your information to the right place

30. Key messages
The social prescribing system is improving – from November 2017 there will be a step change in support and active signposting
The NHS has a key part to play and needs to ensure that many more people receive social prescriptions, to benefit from the range of community opportunities
The system is a partnership. Each part of it needs to play it’s part – community and voluntary organisations already provide social prescriptions

31. Further Information Contacts: Public Health project manager
Public Health Social Prescribing lead
Community Navigators project,
Commissioning Social Prescribing
National Social Prescribing Network (1,000+ members)

32. Workshop task
Get together in groups – use your flip charts to record what you discuss
Think about:
What ‘social prescriptions’ do you offer?
List them (make sure you write your organisation name down)
Do your prescriptions meet the ‘quality’ criteria? Discuss
How could you engage with the Social Prescribing system?
Discuss