- 21 August 2019
Linda Hindle, Deputy Chief AHP Officer, Public health England and Caroline Poole, Deputy Clinical Director and Professional Head of Allied Health Professions (AHPs), NHS England & NHS Improvement, outline a new framework for social prescribing AHPs.
Social prescribing, sometimes referred to as community referral, is a means of enabling people to be referred to a range of local, non-medical services. Social prescribing and community-based support is part of the NHS Long-Term Plan’s commitment to make personalised care business as usual across the health and care system in England. The NHS Long Term Plan published in January 2019 has a commitment to personalised care and increasing access to social prescribing for the whole population.
Recognising that people’s health and wellbeing is determined primarily by a range of social, economic and environmental factors which are often beyond the scope of the healthcare professionals’ traditional practice; social prescribing seeks to address people’s needs in a holistic way. It also aims to support people to take greater control of their own health which has benefits not only for people and populations, but also for healthcare practitioners. In fact, social prescribing is listed as one of the 10 High Impact Actions to reduce GP workload.
Demands on health and social care provision are increasing as people live longer, with more complex health and care needs. Health professionals are recognising the opportunities to address the non-medical determinants of health and wellbeing to support people to achieve optimal health and wellbeing outcomes. As we learn more about supporting self-management and increasing patient activation; clinicians are challenging the medical model that so often prevails, demanding we develop biopsychosocial models of care to deliver holistic, high value, high impact care.
Social prescribing can meet a wide range of needs, with many schemes aiming to improve mental health and physical wellbeing. It can be used to support adults, young people and children as well as people with learning disabilities or mental health problems. It can take place in primary and secondary care. Social prescribing can help to address social issues such as debt, unemployment, gambling and loneliness. This approach to holistic care is not new to allied health professionals who frequently have conversations and provide support related to the wider factors influencing the health of the people they work with.
To illustrate the way AHPs already support this agenda and to provide a framework to support them to do more; a new social prescribing framework for AHPs has been developed by RSPH, Public Health England, NHS Improvement and NHS England along with AHP professional bodies and voluntary sector partners.
The framework is divided into 4 sections to reflect the varying intensity of AHP interventions, these include:
A light-touch approach where staff provide information and choice to signpost people to services, using local knowledge and resource directories. This works best for clients who are confident and skilled enough to find their own way to services after a brief conversation.
Referral to a link worker
In cases where a person needs more support than active signposting can provide, it may be appropriate to refer them to non-medical link workers who can provide more time to understand what matters to the individual and connect them to relevant community groups and other agencies for practical and emotional support.
Undertaking social prescribing
AHPs are likely to undertake social prescribing themselves when they are already providing long-term intensive support to a person as part of their job role. It will involve supporting people to work out which local groups and services would be beneficial to them and helping them to access them in a variety of ways. You may need to work through multiple options with a client and accompany them on first visits. Some AHPs are more likely to do this than others because of the nature of their role.
Supporting the development of social prescribing
For example by providing community groups and services and providing guidance, supervision and training to link workers.
Over 2500 AHPs engaged with the development of this framework by completing a survey, joining a twitter chat, providing feedback on early drafts and submitting case studies. This shows the enthusiasm for this agenda amongst the professions. We hope the framework will support all AHPs to articulate their current role in social prescribing and consider how they could do more.