SOCIAL PRESCRIBING IN THE COMMUNITY BROMLEY BY BOW CENTRE PRESENTATION

July 2014

Social Determinants of Health

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

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

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

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

Outcomes

75% said that it had resolved or partially resolved the issue

70% said it had made a significant improvement in their lives

70% of patients said that they would not have accessed the service otherwise

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

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

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)