Learning from Network 1

Learning from Network 1

Our first network meeting was held on the 27th February and was attended by 30 people across the voluntary sector, public health and the NHS. The discussions will inform our development of the social prescribing model in Southwark over the year.

The main questions we discussed were:

  1. What does great social prescribing look like?
  2. What is currently available in Southwark?
  3. Where are the gaps in the support available?

During our first discussion on what great social prescribing looks like we came up with the following ideas:

Great social prescribing is…

  • A way of being – it’s a culture rather than something we do to people. It benefits all of us at different stages and we all access social prescribing at different times
  • Accessible – not only through GPs, needs to be social workers, community etc
  • Flexible to meet people’s needs - not time limited
  • Holistic and asset-based approach 
  • Enables development and building of local groups alongside
  • Makes use of community champions 
  • Based on intelligence, wider determinants of health
  • Rich mix of offer and activity and choice
  • Understanding what people love to do 
  • Uses shared outcomes 
  • Variety of professional prescribers
  • Clear pathway for prescribers
  • Mapping of services 
  • An integrated service
  • Outreach – making everyone aware of service 
  • Understanding the limitations of VCS support
  • Understanding that building relationships is the most important thing – need a named contact in each service
  • Need Care Coordinator role – to support people through the process, single point of access (localised so know the services)

2. What is currently available? 

During our discussion on what is currently available, we mapped out some of the services and activities that provide elements of social prescribing for four patients with long term conditions. This is not an exhaustive list and only reflects conversations from the day which will be added to through the review of social prescribing:

  • Navigation services to support people to access community activities. These included Age UK Lewisham and Southwark, Alzheimers’ Society, Pembroke House, Time and Talents, Primary Care Navigators, the High Intensity Users team and the British Red Cross discharge service. 
  • Access to volunteering through Community Southwark and Paxton Green Timebank for skills sharing
  • Peer to peer support through the Wellbeing Hub and Diabetes support group at Inspire, COPD choir
  • Mental health support through IAPT (Improved Access to Psychological Therapies), Blackfriars Settlement
  • Carers’ support through Southwark Carers, Carers’ café and Alzheimers’ Society
  • Financial /legal/housing support through Advising Communities, Citizens Advice Southwark, Southwark Law Centre and Peabody housing association
  • Physical exercise through Sporting Recovery, leisure centres, exercise classes  

These are some of the directories people currently use to find local opportunities:

We also discussed where there are gaps in support provision. We specifically looked at the underrepresentation of different groups of people; gaps in certain service provision; where people are falling through the gaps; and where social prescribing is less effective.

3. Gaps in support

Demographics 

Housebound (especially those with mental/ emotional causes)

Language/ cultural barriers - smaller population BME

Men often more socially isolated

Migrant and emerging migrant communities

People with No Recourse to Public Funds 

Communication needs/ illiteracy

Complex needs – physical or mental health

People with sensory needs – deaf, blind etc

Pockets of deprivation (need to tailor services, gather better data)


Provision of services 

Some areas of the borough lack activities eg South Dulwich, Nunhead 

Lack of translation or not enough to meet need/ not known about 

Lack of out of hours services

Lack of peer to peer support networks 

Befriending for people with mental health needs/ disabled 

Housing – incl mental health needs and continuation of support 

Comprehensive information source

Networks for sharing info – central pathway, neighbourhood models 

Unified approach to initial contacts and central point of contact for providers/ services in the system – named liaison rep for major provider

Need upskilling of signposting and navigation in disparate services

Lack of long term/ support work 

Longer term walking buddy/ training to improve mobility 

No service to support with managing post/ correspondence

MS or specific diseases

Lack of lower level/ preventative mental health support

 

Access points 

Over reliance on GPs/ primary care

People not accessing GPs (“Silent Years”)

Need grass roots local connectors/ champions

Lack of visibility of local offer

Physical accessibility of space

Communication/ language

Transport barriers for people with dementia/ poor mobility

Need training for providers eg COPD management

Need to go where people are – churches, faith groups, football, libraries, barbers

PCNs underused but have so little time to spend with people

Digital platforms often out of date. Need to have details of what Navigators do, referral criteria and point of contact


Where is it less effective?

Outcomes are not met as well when they aren’t person centred

Numerous test and learns, pilots, always trying to innovate, sometimes the basics work best

Silo working and duplicating efforts

For people who have eligible needs and require ASC support

Funding streams less defined

GPs not knowing where to prescribe

Communications only in English eg texts from GP surgeries

Translation services for navigators not resourced

People caught between referral criteria

Fear to work outside the box (eg fear of safeguarding issues/ health and safety - pushing  wheelchairs

Social prescribing isn’t appropriate for people in crisis but often the last resort

Rigid timeframes – need flexibility

 

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