Facilitator: Barbara Wonford Comments and feedback from the Blue group 1. Everyone was asked if they were clear about what they thought social prescribing meant. Everyone said that in their service they signposted their clients on to different services, according to need. Perhaps the term Community Prescribing makes it clearer? It was agreed that signposting was different to social prescribing a means whereby GPs can refer their patients on to local and non-clinical services to support them with emotional or practical needs. These services are often provided by the voluntary and community sector but also include access to green spaces. They could be practical such as advice on debt and housing, or social such as referrals to walking groups. 2. It was agreed that GPs are unlikely to provide specific information in relation to social prescribing options given the amount of information they are already expected to retain. A preferred model is to have a single point of contact which GPs can refer patients to. 3. The consensus was that funding for a social prescribing project should come from GPs or the CCG but given the pressures on primary care at this time, this is likely to be difficult particularly if they re unable to see the benefits to the practice e.g. a reduction in visits. It would be helpful for any social prescribing model to target frequent attenders for example. 4. A localised social prescribing model may be more effective than a Borough wide model since patients are likely to want to access activities in their immediate area although options to go further afield should also be available. The single point of contact might be based in a GP practice, but with a remit to support additional Practices near them (similar to the Early Years services model which is split into areas). 5. Is there a list of voluntary and community organisations already in existence? If not, there needs to be one. 6. Voluntary organisations might be prepared to rotate around different practices, according to local demand. 7. The GP could use a social prescription pad to refer the patient to the nearest single point of contact. 8. Funding should be sought to appoint several community health champions based in GP practices (like the existing model in the London Road Surgery). Could an application be made for 3 year Lottery Funding if there is no funding available from the CCG? Are there other external funding opportunities? 9. Could existing teams be utilised i.e. Early Help teams, to provide a single point of contact? It was felt that whilst these teams have a specific role to support parents and families, they would not be in a position to support adults outside of the family environment plus they are likely to have limited capacity to expand their current role. It could be worth exploring whether the Lifestyle Hub, run by Bedford Hospital, could expand to become a single point of contact for social prescribing too. 1
Facilitator: Jane Owen For non-clinical things, GPS need a middle-man - Don t have time - Don t know/information overload Livability already do this Practice Manager Comments and feedback from the yellow group Direct Payments NHS & Public Health 2 different budgets Lifestyle Hub Weight Management, Healthy Activities BUT - Application. Wait for service. Then only 10 weeks. CCG 6 practices, involvement in creating a Suicide Assessment Tool for GP s refer to support. Samaritans - 24 hour emotional support while waiting for intervention to avoid crisis Links with Suicide Assessment Tool used by GP s. Referrals low because too much information (despite enthusiasm!). Radio Show on Community Health & Publicity eg. Why don t people access services? Stigma/judgement/too official Even experts can t find the info in one place Preconceived ideas about services. Language barriers etc So many groups & leaflets Someone to listen & have knowledge about groups/services More likely to do it if the GP tells them to! Especially possibly older people and ethnic groups maybe. What resources do GP Practices have that we can use? TV screen would we do this together? Do our leaflets & posters get binned? Space in Health Centres? Care Act Capacity & we can t get the staff. 2
Responsibilities Is your service quality going to go down with more users? Living wage & funding cuts How does the champion cope with different needs? Translator, LD etc. Maybe the existing stuff is enough? Maybe it s just about better links. Could a website do this? GP websites link to a central website? Advice central in Central Beds = Advice hub extend to health & other issues. FIS CAB Lots of these GPS/CCG Funding & Public Health? FINANCE GP Paid for gardening equipment Free Gym passes EVIDENCE BASE What do we save by not seeing GP so often Early intervention saves money. 3
Facilitator: Steve McNay Navigator role? Comments and feedback from the Orange group Individual GP Practice Cluster Hub Outcomes from pilot scheme essential. Evidence of cost savings needed If we have x no. of Simons, we will save y amount of money. Database accessible to others (eg CPN s, HV s, etc.) to enable them to direct appropriately. Questions Answers What do GPs do now? Are other GP s considering the HC role Can we sell this to the Borough as a whole, rather than piecemeal - individual GPs. Reduced demand on health/social care/cj etc Individual soft outcomes. Self-assessment for mid accessing support with follow up. Practice based triage/self-referral Proven social impact (LD & MH learning) Engagement with GP s/health Practice manager, receptionist, nurse, prac etc. GUM clinic for HIV Support Is there a role for the CCG to facilitate introduction GP s VCSE. Probation, schools, etc also potential referrers. GPs ARE referring to Food Banks Link onwards? Some agencies are self-sufficient and have capacity Could work without additional funding. Challenges How to make it sustainable? Is there any funding attached? Who pays? Health visitors have been useful. 4
Facilitator: Simon Gooch Relevance: Comments and feedback from the Green group More relevant for some delegates compared to others. Those who had no interest/need to access primary care did suggest that a more comprehensive single portal of information would enable them to signpost more efficiently. Some delegates had heard of social prescribing before and others had not (70:30). Group agreed that it could solve issues related to making GPs aware of their services, however it could also cause problems if patients are not signposted properly. Efficient communication is essential. Mechanism: It could be hard to maintain a local approach if a social prescribing project became larger with more funding. Community was discussed at various points and most delegates felt this was necessary. Delegates thought that an official pathway with different levels would be needed. Follow up support would need to be addressed. Official referrals could be relevant for some groups but not others. Clear outline of what services offer and a facilitator that is aware of this. Most delegates agreed that a facilitator or navigator is essential. Could social prescribing be integrated into the current ELFT mental health services? Finance: A method for groups/organisations to get health based outcomes to support grant proposals. If there are more people engaging with their services they may not be able to cope. Some sort of tendering/grant scheme built into a social prescribing scheme would be good. Where is the money going to come from? Summary Delegates enjoyed discussing the subject with some interested in joining the steering group and all have done some useful networking. 5
Joining Up Services Community Support Mechanism Opportunities Support without Medication The reduction of need by use of Community Services that exist Communication Quality times Community information Helping people 6