1. Stockton Service Navigation Project
Welcome, may name is Tom and I have here to raise awareness of the Stockton Service Navigation
SSNP is a social prescribing service that aims to increase clients confidence, control and independence, while supporting them to reduce stress and isolation, improving clients quality of life.   
We direct clients, based on there interests to a range of activities for example:
walking groups
creative arts groups
exercise classes
learning opportunities
social group
Etc to support individual’s health and well-being.
The service also signpost and support clients to access other sources of support such as the Citizens Advice Bureau, education providers, counselling, volunteering opportunities and job clubs

2. Service Aims Give Connect Get Active Keep Learning Take notice
The service aims to help clients to take small but significant steps which will improve there health and wellbeing and make positive life changes. ​
Connect - With the people around you; your family, friends, colleagues and neighbours. We can help you find a social activity to help make new friendships.
Get active - Physical activity makes us feel good. We can help you find an activity that you enjoy & suits your level of fitness; such as an exercise class or walking group.
Learn - Learning new skills can give you a sense of achievement and a new confidence. We can help you find a creative arts class or a course which interests you.
Give - Whether it's a thank you, a kind word or volunteering your time. Helping others makes you feel good about yourself and we can help you find the right opportunity.
Take Notice/Get support - We can help you access the right kind of support such as benefit, debt or fuel poverty advice.

3. Common Client Themes Loneliness Welfare Reform Depression Low Income
Poverty
Opportunities
Age
Personal Barriers
Skills/Knowledge
Welfare Reform
Low Self-Esteem
Anxiety
Social Isolation
Through our work we have found that a significant percentage of SSNP clients are lonely and social isolated
Often our clients are impacted by a variety of contributory factors including: low income (poverty), age, limited opportunities, impact of welfare reform.
Many clients present with low levels of confidence, self esteem and many suffer with anxiety and depression.
Case Study: An example of a client working with SSNP: Originally accessed the service due to isolation and feelings of low self worth. Even though she is a full time carer of her disabled daughter she felt she had nothing for herself, she was on medication for depression but felt this made her worse. Since working with the SSNP she has now stopped taking antidepressant medication, she now participates in numerous health walks, and groups. She is volunteering and sharing her experiences with others in the aim of using her experiences to assist others in making positive life changes.
From taking steps and having services in place, she now attends the GP practice less, the expense of medication for her mental health no longer exists and she is using her skills to give back to the community.
Low Confidence
Depression

4. Supporting individuals
No Wrong Door Approach
Provide 1:1 and Group Sessions
4 Appointments per Client
Supporting Client’s to Overcome Barriers
Flexibility
Our service has a No Wrong Door Approach
Our clients can self refer or be referred by another service
We support between clients per navigator either on a 1:1 basis of in a group setting
Each client is offered up to 4 appointments, in most instances clients only usually require 2-3 appointments per intervention
In some instances clients may need more support to help them over barriers, for example low confidence or anxiety
To meet the needs of the clients we provide with the option of meeting with the Navigator at our office or in a suitable location which is mutually agreed upon. For example: cafés, libraries or community venues.
We do try to have clients meet us at the office or in a suitable venue as we like to get them out of the house and into the community.

5. Client Pathway Connect: Referral Follow Up Initial Contact
Warwick Edinburgh Mental Well-Being Scale Post Assessment
Connect:
Social prescriptions co-created and introductions made to providers of community based activities… Aiming to improve the social connectedness of clients to engage, empower and build resilience.
Referral
Initial Contact
Initial Assessment
Client Goal Setting
Advocacy Support
Follow Up
The client journey can be broken down into 6 steps.
Client can be referred in via a third party or can self refer
Client is contacted and the boundaries of the service are outlined to ensure clients expectations are managed with integrity
An Initial Holistic Assessment is completed to determine the wider determinants of health
Working with the client the navigator encourage the client to set goals and develop a personalised action plan
The Navigator will support for clients to access services and make connections with their communities
Destination tracking and follow up
Warwick Edinburgh Mental Well-Being Scale Pre Assessment

6. Working within the Local Community
Stockton And District Advice and Information Service
Job Centres (Billingham, Thornaby & Stockton)
GP Surgeries (4 drop-in services established)
A Way Out (Refuge for Vulnerable Women)
Accent Housing (Social Housing Provider)
To facilitate client engagement and sign up we also provide a number of outreach/drop in sessions
Stockton And District Advice and Information Service
Job Centres; GP Offices; Queens Park Medical Centre & Tennant Street Medical Practice
A Way Out Accent Housing

7. Partnership Working GP’s Job Centre’s VCSE Agencies Community Groups
Adult Learning Providers
Social Housing
Our Staff Team have developed strong working relationships and networks with a number of organisations and groups to facilitate referral into SSNP. This has been achieved via completing an asset mapping assessment in 2017 which identified:
Who offered support
What at support was available
Eligibility criteria
The team them worked hard to find ways to close any gaps in support identified, for example; by offering free health and wellbeing programmes for anyone over the age of 16 years of age.
The relationships developed by this and over exercises, benefit both our clients and partners, and enables navigators signpost effectively, provide accurate support and advice and facilitate access to local services. We now work with and extensive range of groups and organisations including;
Alliance, Mind (Specialist Mental Health Interventions)
Badminton Group, Craft courses,
Billingham Baptist Church
British Red Cross (Volunteering Opportunities)
Butterwick Hospice (Bereavement Support and End of Life Care)
Citizens Advice Bureau (Welfare , Financial advice and debt management support)
Cruse Bereavement, Lifeline (Drug and Alcohol Support)
Daisy Chain (Specialist Autism Support)
Knitting Groups, Social Activity Groups
Adult Learning Providers (Various)

8. Service Achievements Since the service was established in 2012.
Over 2000 clients have been supported by the SSNP Navigator.

9. Service Achievements in 2017/18
100% Service Satisfaction
89% Increase in Knowledge
100% Service Accessibility
86% Increase in Social Interaction
95% Increase in
Confidence
337 Clients Supported by
1 Navigator
As you can see we have had some significant impacts and the service model also represents value for money. 1 Navigator supported 337 clients in 1 year.

10. Project Challenges Service Demand (1 WTE Navigator)
Employment Opportunities
Funding Cuts
Barriers to engagement (Health & Social care)
Buy in to a Social Prescribing model
Communication with NHS
Difficulty capturing impact in terms of medical data (prescriptions/appointments)
The project has to deal with a number of challenges:
The demand for the service is increasing
Clients are increasingly struggling to find employment due to what they feel is a lack of opportunities. These leads to client having no confidence or hope. To over come this the project links clients to voluntary and social activities this can assist the client in regaining confidence, learning new skills, and also identify new opportunities, giving back hope.
Funding cuts and increased demand on services is hampering health Services. SSNP works alongside several practices with the aim to alleviate the continued stretch on resources, with the primary purpose of reducing appointments booked, waiting times, and the rising cost of traditional medication.
We have experienced difficulties establishing the SSNP within some GP practices within the Borough. There is a distinct need to intergrade the social and clinical models of health to ensure clients are provided with holistic support. This requires a joined up approach from health care practitioners and Social Prescribers (Navigators). Currently, we have established the service with Tennant Street and Queens Park Medical where we deliver valuable support to their patients through regular drop-in surgeries.
The SSNP Navigator is currently unable to access NHS patient records (System 1), this access would provide a more robust assessment of need and support the development of an integrated care pathway (social and clinical).
Current intelligence (data capture) does not permit the SSNP navigator to measure impact in context to potential reduced use of medical prescriptions and the number of appointments with the GP.

11. Meet the Team Strategic Development Management Support
Project Delivery
Nigel Brough
Head of Projects
Toni McHale
Project Development
Manager
The team consists of (FTE) Navigator/Link Worker (Tom).
Management support is provided through a Project Lead (Karen Grundy) who functionally line manages the SSNP Navigator (Tom).
Additional capacity is provided in context to Strategic development by the PCP Senior Management team.
Karen Grundy
Project Lead
Tom Mohan
Navigator/Link Worker