Social Prescribing

Enabling the development of social prescribing models to cope with the rising demand for community support coupled with capitalising on emerging new roles to support primary care are going to be key to Primary Care in helping cope with the additional demand that the pandemic has created.

The NHS Long Term Plan highlighted Social Prescribing as a key element in the prevention workstream and the Network Contract DES for 2020/21 has stated its commitment for expanding social prescribing services across Primary Care Networks which is welcome news, as there is now perhaps greater recognition of the importance of connectivity and coordination of support-based activities for now, during the crisis, but also for the future.

The review published in February by the Institute of Health Equity concluded that health is getting worse for people living in more deprived localities and regions, health inequalities in England are increasing for people living in more deprived localities and regions and, for the population, health is declining. This decline will need to be addresses if we are to achieve that set out in the Long Term Plan.

PCNs in partnership with Local Authorities and other local agencies, can look to build a local system that could address some of the challenges faced by their local populations relating to the wider determinants of health, and close the gap in health inequalities.

PCNs have the opportunity to utilise the Additional Roles Reimbursement Scheme to fund any of the ‘new roles’ including the health and wellbeing coach and care coordinators. Both roles would fit well into a social prescribing service. Health coaches will be able to focus on helping patients with low initial patient activation measure scores or with complex or multiple issues allowing Care coordinators to provide a supportive function, focusing on patients likely to require more straightforward signposting to community groups.

It makes sense that PCNs may want to consider delivery models which allow link workers (and future roles) to work for the PCN collectively, as part of a social prescribing team, receiving referrals from each practice which undergo a triage function to ascertain priority/urgency and the individuals ‘need’ and are then allocated to the appropriate team member.

We should not forget that the success of social prescribing models will depend on the combined success of each intervention. This can be increasing more difficult if you do not have any, or limited referral pathways available. There are likely to be several gaps arising as the charitable third sector have seen such a decline in funding over recent years which has only been exacerbated by the pandemic.

Whichever way PCNs choose to work with their local communities and utilise the additional roles available to them, there has never been a greater need for services such as social prescribing and it is likely that these will become embedded in primary care for the foreseeable future.