Developing non-clinical approaches and are pathways to fundamental socioeconomic issues that are presented in the primary care and secondary care settings
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1. Social PrecribingDeveloping effective interventions in the
PrimaryCare environment based on health andsocioeconomic need. A
Therapeutic Model
2. What is Social Prescribing?Social prescribing has been quite
widely used forpeople with mild to moderate mental healthproblems,
and has shown a range of positiveoutcomes, including emotional,
cognitive andsocial benefits. Social prescribing may also be aroute
to reducing social exclusion, both fordisadvantaged, isolated and
vulnerablepopulations in general, and for people withenduring
mental health problems (Bates 2002;Gask et al. 2000).
3. What are the advantages?Reduction in need for clinical or
secondary careReduced need for prescriptive interventionDevelops
patient autonomyIncreases awareness of alternative carepathways
using non-clinical approachesAcknowledges patients socioeconomic
andcomorbid health needs
4. When to prescribe?We all use assessment material to measure
anindividuals mental well being, PHQ 9 for example.But what other
information lies beyond the numbersthat are generated? Are we
taking into accountother factors that are impacting on their lives?
Dowe have the time? Do we have the skills to addressthese other
factors, provide relevant information orknow where to sign post
them? Social Prescribingfinds the issues that are underpinning
andreinforcing these problems and finds non clinicalpathways to
address them.
5. Based on a US model of deliveryHealth Leads is part of the
clinic team.With Health Leads, doctors, nurses, and social
workerscan focus on the complex clinical issues that they
areuniquely trained to address. By providing an
alternativeworkforce to connect patients with basicresources,
Health Leads enables providers to delivercomprehensive patient
care. In the States the modelcombines a paid worker who serves as
the SocialPrescribing Coordinator with a team of volunteers whoare
able to buddy with clients to guide them throughalternative service
pathways and support their individualor family needs.
6. Health Leads The Health Leads model had a positive impact
onreducing unmet social needs for low-income families.
Thisinnovative multidisciplinary team-based model was able to
connectthe medical home with community-based resources, often
adaunting task within the current primary care
modelLegalUtilitiesFoodEmploymentEducationHousingBenefits
8. Alternativeto one toonetherapyMindfulnessCrisis
CareSpecialistPsychology/PsychiatryHome
ITAnxietyProgramConditionSpecificGroupReassessedfor
FamilyTherapyMotivationGroupTherapySocialPrescriber
9. iCloudCentralSystemClient DiaryPsycho-educationTools
todownloadClient NotesCentralBookingSystemEmailexchange
&contactfacilityAccess toassessmentmaterialTherapyTools
toaccess inthe home
10. What do Physicians think?4 out 5 of 1000 surveyed (690 from
primary care 310 pediatricians)agree with the following statements
with regard to socialprescribing;Unmet resource needs lead to worse
health outcomesAre not confident in their capacity to address their
patientsneedsSay that patients social needs are as important as
their medicalconditions. This is especially true for physicians
(95%) servingpatients in low-income urban communitiesDoes the US
model reflect UK need and the experience of cliniciansworking in
the primary and secondary sector?Our argument and experience at
LincsTherapy is that the answer isunequivocally yes
11. What would Social Prescription look like in theprimary care
setting?Embedding a project coordinator to sustain a social
prescriptiveproject is as simple as providing a room and IT
capacity.However, if the practice is committed to enabling social
prescriptionthroughout the patients primary care experience then
this has topermeate through each tier of the primary care
model.Dissemination of information and training of staff is key to
enablesign posting of patients prior to referral to a clinician.
The voluntarysector model of the use of volunteers to provide much
of the servicewill be key; not only economically but this will
enable individuals andfamilies to navigate an often confusing
system of health andsocioeconomic care system without the
intervention of traditionalcostly secondary services.
12. Economic impact for the commissionerFull time coordinator
would be based on the current 2013 Band5 NHS salary
structureVolunteers would receive expenses and trainingManagement
fees would constitute 15% of the total cost of theserviceProvision
and price of other services i.e. therapy andconsultancy would be
based on an ad hoc basis orcommissioned contractual
arrangementProvision of IT capacity access to terminalsLincsTherapy
is an eclectic organisation and provides services thatmeet need and
expectations within the public sector and iscommitted to continuous
growth identifying new and innovativeways to tackle the challenges
that are representative of anincreasing demanding world and the
complexities of 21st Centuryhealth care.
13. ConclusionIt is clear that there is a growing need to
provide a servicewhich addresses the issues that are not evident
within theclinical diagnostic environment yet are having a
profoundimpact on individuals and families lives. It is also
clearthat clinicians time can be used more effectively if
thesenon-clinical issues are met within primary care andsupport
physicians to meet the complex demands thatthey are faced
with.Social Prescribing can provide the evidence basedeffective
service that meets the growing socioeconomicburden people are faced
with each day of their lives. It isnot a vehicle to relinquish
personal responsibility whenmet with hardship; it recognizes that
people need to beable to connect with services that improve well
being andcompliment clinical delivery and this burden of need hasto
be shouldered by all of those throughout thepublic, private and
voluntary sector tasked with theprovision of care.