Social prescribing in County Durham

Better quality of life through integrated health and care services Our priorities 2018 - 2020 Better quality of life through integrated health and care services Mental Health at scale Positive behaviour change – smoking, activity and food Every child to have the best start in life Our healthy workforce Good jobs and places to live, learn and play During 2018, we have been developing a new vision for public health in Durham. It has been developed through a review of the evidence, and has been grounded and supported through consultation with DCC colleagues, Cabinet and partners Here are our overarching priorities as a team for 2018-20. They are supported by 16 additional short and longer term aims. They are based around the Joint Strategic Needs Assessment and DPH /Corporate priorities Together they guide the work of the team and the conversations we will hold with partners Whilst they don’t cover the entirety of the work we do they will focus our attention in order to achieve greater gain through alignment of activities and focused effort. Excellent drug and alcohol service provision

Social prescribing Social prescribing and community-based support is part of the NHS Long-Term Plan’s commitment to make personalised care business as usual across the health and care system. Personalised Care means people have choice and control over the way their care is planned and delivered, based on ‘what matters’ to them and their individual strengths and needs.

Social prescribing This happens within a system that makes the most of the expertise, capacity and potential of people, families and communities in delivering better outcomes and experiences. What is social prescribing? Social prescribing enables all local agencies to refer people to a link worker.

NHS Long Term Plan 1.40. As part of this work, through social prescribing the range of support available to people will widen, diversify and become accessible across the country. Link workers within primary care networks will work with people to develop tailored plans and connect them to local groups and support services. Over 1,000 trained social prescribing link workers will be in place by the end of 2020/21 rising further by 2023/24, with the aim that over 900,000 people are able to be referred to social prescribing schemes by then. This number would suggest 9 link workers in County Durham At the moment there are about 59.7 million patients registered with GPs who make over 240 million appointments a year. compared to the 900,000 a year promised for Social Prescribing. This means that in 5 years time social prescribing activity will be equivalent to .38% of appointments at GPs I mentioned in an earlier blog on Welfare Rights and Health that a joint paper produced by Citizens Advice and the Royal College of General Practice estimated that approximately 20% of GP time was spent with patients who presented with non clinical issues that would be better addressed elsewhere.

The benefits Social prescribing particularly works for a wide range of people, including people: with one or more long-term conditions (1/3 of residents) who need support with their mental health (1 in 4 people ) who are lonely or isolated (46% of County Durham) who have complex social needs which affect their wellbeing ? Consider this in the context of County Durham’s population of 523,000

More than a GP referral When social prescribing works well, people can be easily referred to local social prescribing link workers from a wide range of local agencies, including general practice, local authorities, pharmacies, multi-disciplinary teams, hospital discharge teams, allied health professionals, fire service, police, job centres, social care services, housing associations and voluntary, community and social enterprise (VCSE) organisations. Self-referral is also encouraged.

The theory is good Certainly there is good evidence that getting people involved in community life, keeping them active and improving social connections – all of which are hallmarks of social prescribing – is good for both health and wellbeing. Link workers have strong knowledge of local community groups, map community assets, recognise gaps in community provision and find creative ways of encouraging asset-based community development approaches, alongside local commissioners and partners.

What might it look like in County Durham?

Single point of contact? General practice Diagnosis of an illness Single point of contact? Link workers Prescribe a treatment for a disease The community Social factors

Social model of health Community resilience Fire and rescue service Frontline local authority services The community General practice Social model of health Single point of contact? Link workers Link workers Community resilience Social factors i.e. AiCD Social model for health – social, economic and environmental change Community resilience is a measure of the sustained ability of a community to utilize available resources to respond to, withstand, and recover from adverse situations. The community Assets

Locally, a great resource. www.durhaminsight.info

Community-centred approaches for health and wellbeing Local government and the NHS, together with the third sector, have vital roles to play in building confident and connected communities as part of efforts to improve health and reduce health inequalities. Community-centred approaches seek to mobilise the assets within communities, promote equity and increase people’s control over their health and lives. Important to support communities and recognise the social model of health Therefore are efforts required across the whole system?