Agenda item

Social Prescribing

Presentation by Janet Wheatley,VAR


Janet Wheatley, Chief Executive, Voluntary Action Rotherham, gave the following powerpoint presentation:-


Rotherham Social Prescribing

-          Sits alongside clinical interventions – helps people live their lives in a way that feels like living rather than coping and surviving.  It provides an integrated response to patient care

-          Where the NHS ‘meets’ the community and its assets – shifting the focus from conditions or ages to localities and communities

-          ‘what matters to me’ as well as ‘what is a matter with me’

-          Involved a leap of faith to working differently – there had to be another dimension to meeting patient needs

-          Co-produced – between Rotherham CCG, VCS and service users

-          Builds on/enhances local relationships, respect and trust between public sector and voluntary and community sector partners

-          Flexible to meet changing needs – embedded within CCT and STP

-          Supports and resources VCS – works with groups and patients

-          Independent evaluation base – evaluated from onset


The ‘Rotherham Model’

-          Voluntary Action Rotherham (VAR) on behalf of Rotherham CCG delivers 2 Social Prescribing (SPS) programmes.  VAR manages the programme and micro-commissions activity from the VCS – contracts/spot purchases/grants

-          LTC SPS works with all GP practices as part of integrated case management approach.  Referral pathway identifies patients referred to a VCS advisor aligned to each GP practice.  Started 2012 – 5,835 referrals

-          Mental Health SPS works with 2 cluster groups of patients referred by RDaSH to a VCS advisor.  Operating since 2014 – 328 referrals

-          Patients/service users build and direct their own packages of support, tailored to their specific needs by encouraging them to access services provided by the VCS


Rotherham SPS Research

-          We have a rich and systematic evidence base to support our work – both schemes have been independently, academically evaluated from the start

-          The evaluations track two main elements:-

       Improvement in wellbeing and quality of life

       Impact on services either in reduction in demand or potential for discharge/step down

-          Plus patients/users stories through case studies


Research Findings

-          Health and wellbeing – consistently large improvements in wellbeing for all patients/service users referred.  Over 80% improvement for LTC patients and over 90% for MH service users

-          Reduction in demand for services – for the LTC service consistent reductions in use of services 6-11% reduction in non-elective inpatient stays and 13-17% reduction in use of A&E services – more detailed analysis shows higher reductions in certain types of patients.  For the MHS over 50% discharge from services for those eligible for discharge review

-          Financial savings – the above evidence translates into definitive cost avoidance savings for the NHS


Additional Research Findings – Impact on Primary Care

Latest evaluation looks at impact from a GP perspective

-          Face to face appointments reduced 28%/telephone consultations reduced 14% (tracked in 1 GP practice)

-          Opportunity for holistic response to patient care.  A person centred service especially for those with complex needs

-          Helps patients manage symptoms.  Some impact on medication usage

-          Rotherham SPS also supports carers – helps with family and care breakdown


Additional Research Findings – Impact – Voluntary/Community Sector

-          SPS is a route into delivering a community asset based approach to health – connects, through a single gateway, voluntary and small community groups into wider healthcare delivery.  It taps into the potential out there in communities and within individuals

-          It supports the VCS to deliver options and solutions to people’s needs.  Rotherham’s model provides funding to front line VCS organisations.  It is a resourced intervention rather than just signposting to already overstretched VCS services

-          We work with VCS groups alongside SPS users – help secure additional funding, volunteers, diversify income, new activities, increase citizen engagement/independence/resilience.  It helps rather hinders VCS sustainability


Essential Lessons Learned

-          Be clear about the outcomes/target population and clarity on the model – is it SPS ‘lite’ or intensive/signposting or prescription

-          Keep the model and referral mechanisms simple – single gateway

-          Keep it local – knowledge and expertise out there from local VCS.  The perils and benefits of scaling up

-          Role of link workers/advisors – linked to practices/localities part of MDT team – build the relationships and combine expertise

-          Importance of patient/user to be in charge/have responsibility for their care – do not overcomplicate some of the solutions

-          Resource the sector to deliver the solutions – this will enable them to come up with further sustainable options

-          Evidence base – what target needs are and what works

-          3 Rs – Relationship, Research, Resources


Rotherham’s Success Story

-          The Rotherham SPS model is seen as leading the way across England in the delivery of SPS.  Praised in NHS Five Year Forward View

-          We have been visited/visit over 120 different areas across England and Wales.  We receive 2/3 enquiries monthly about our work

-          We have presented at numerous conferences including Kings Fund major conference, met with the Secretary of State, attended a launch at the Home of Commons and won awards

-          We anticipate a roll out of SPS nationally and we believe Rotherham will be asked to be at the forefront of it


SPS where next – National/Regional/Local

-          Nationally – announcements on a national rollout of SPS are due

-          Regionally via STP – inclusion in the Place Plans and STP workstreams.  Also link between SPS and the Work and Health programme

-          Locally – potential to target other cohorts e.g.

Isolated and lonely/vulnerable/socially excluded/disadvantages – linked to MECC

People with mild to moderate mental health conditions

People with health related employment issues e.g. MSK/Mental Health – linked to work and health

Certain health conditions – e.g. cancer patients/Diabetes or a specific community/locality based approach

Children and young people


Discussion ensued with the following issues raised/clarified:-


·           Social Prescribing was not available to everyone.  There was an ‘at risk’ register of intensive users of services


·           £1M of identified benefits and thought that the GP benefits was understated – the social benefit had not been identified as yet


·           This cohort of patients were the ones that medicines were not working for


·           Opportunity to explore how it might work with children and families


·           Ongoing discussions as to whether the resources could be utilised for those in mental health crisis and linking into prevention of suicides


Resolved:-  That the presentation be noted.