1. Social Prescribing in the Community Bromley by bow centre presentation
July 2014

2. Social Determinants of Health

3. The issue we sought to address
Over 50% of health need is socially determined.
Areas where the population has poor social determinants of health, such as Tower Hamlets, have the following characteristics :
Over-representation of long term conditions such as diabetes
Late presentations of cancer
Lower than average life expectancy
High levels of depression
High rates of child and adult obesity
High rates of GP consultation, prescribing and admissions

4. The logic for social prescribing
Improving social determinants of health improves people’s knowledge, skills, confidence and conditions to lead a healthy lifestyle
Unique position of healthcare professionals to understand patient needs
A referral made by a healthcare professional carries authority
Healthcare professionals do not always know what community services are available and how to refer patients to them

5. How we established a social prescribing function and embedded it in five GP practices
Built relationships with patients, service providers & GP practices
Collated a directory of local services & providers
Embedded a simple referral form, to be used to refer to all services, in practices’ EMIS systems
Co-ordinator managed all referrals & supported them to access a range of local services
Follow up surveys, interviews & informal conversations to evaluate & refine the service; feedback given to GP practices

6. Referrals Referral rates:
331 referrals received in 6 month pilot; currently receiving 100+ per month
Increasing number of referrals have more complex needs
Referral services:
70% health programmes (e.g. Health Trainers)
20% services for vulnerable people (e.g. older people, people with mental health issues)
10% employment support, adult learning and/or welfare advice

7. 75% said that it had resolved or partially resolved the issue
Outcomes
70% said it had made a significant improvement in their lives
75% said that it had resolved or partially resolved the issue
70% of patients said that they would not have accessed the service otherwise

8. The need for social prescribing for cancer patients
25% - 60% of cancer survivors have unmet social needs, which impacts their health and wellbeing
There is limited coordination between the services and support offered by the health and voluntary sectors, which contributes to poor cancer patient experience
As an increasing number of people are living with or beyond cancer, un-met social needs will become a problem for more people

9. The aims of a cancer specific social prescribing service
Improve quality of life
Raise awareness of the value of community services
Support integration of care and support
Reduce demand on health services

10. Development of a cancer specific social prescribing service
Work with key stakeholders (e.g. CNSs, GPs, Barts Health NHS Trust, Macmillan Cancer Support, London Cancer, existing social prescribing services)
Scope a cancer specific social prescribing service across East London over four months
Integrate with primary care and secondary care through linking with the Recovery Care Package (Holistic Needs Assessment and Cancer Care Review)