Social Prescribing is a core element of the co-production revolution and the fact that the Welsh Government has tabled this debate show that we have come a long way since I first led an Assembly Debate on Co-production, to a lukewarm response.
This is about moving from the medical model – which sees illness or disability as “the problem” – to the Social Model of Disability and the right to Independent Living, emphasising that people are disabled by society not themselves, that we must work together to tackle the barriers to access and inclusion for all and that everyone must be allowed independence, choice and control in their lives.
This is about doing things differently moving from a needs- based approaches to strength – based development, to helping people in communities identify the strengths they already have, in order to tackle the root problems preventing them from reaching their potential.
As the Welsh NHS Confederation states
“Engaging the public and patients, and co-production” means “developing and implementing a national programme within an agreed timescale across government which identifies actions for all public services to take to engage public and patients in living healthier lives”.
The King’s Fund definition referred to states that “social prescribing, sometimes referred to as community referral, is a means of enabling GPs, nurses and other primary care professionals to refer people to a range of local, non-clinical services”.
As they say “Social prescribing is designed to support people with a wide range of social, emotional or practical needs, and many schemes are focussed on improving mental health and physical well-being”.
“This can involve a variety of activities which are typically provided by voluntary and community sector organisations. Examples include volunteering, arts activities, group learning, gardening, befriending, cookery, healthy eating advice and a range of sports – involving a link worker who works with people to access local sources of support”.
A study into a social prescribing project in Bristol found improvements in anxiety levels and in feelings about general health and quality of life.
A study of a scheme in Rotherham found reductions in NHS use in terms of accident and emergency attendance, outpatient appointments and inpatient admissions.
Cartrefi Cymru run several projects empowering and enabling older tenants to take control of their lives, not letting their age, or anything else affect them, their independence or quality of life.
In Lancashire, the ‘Green Dreams’ Social Enterprise set up by a local GP provides community-based solutions to unemployment, isolation and reduced quality of life.
Independent evaluation by Lancashire University found mental and physical health improvements, reduced GP appointments and many patients returning to work. Around 40 GPs are now referring into this.
The Co-production Network for Wales highlights Time Credits Social Prescribing as a powerful tool for engaging the hard to engage or socially isolated, in activity that might have a health, wellbeing or family reconnection impact and earns them time credits.
Co-production Wales has highlighted the upcoming 8th June presentation by the Chief Executive of InterLink RCT –connecting individuals, communities and organisations – at a Strengths-based practice study group.
As he says “patients are being referred from GP surgeries through social prescribing; and through social care settings, often called Community Co-ordination or Local Area Co-ordination”.
He adds, however, that “many of the resources available are not directed at what matters most to people, where they need it to improve their own health and wellbeing”, that “this is particularly a problem in more deprived areas” and that “Models that work in isolation, that are not collaborative and are not connected or able to resource community provision will fail to tackle gaps and will be limited in scope and effectiveness”.
Five years ago I heard Western Australia’s inspirational Mental Health Commissioner speaking at a Co-production Wales Conference in Cardiff.
It was he who first launched Local Area Co-ordination, making a real difference for both local people and professionals who started to think and act differently.
This shifted focus from people as “passive recipients of social care” to people who have gifts, assets and contributions in inclusive communities.
Volunteer run walking schemes supported by “Lets Walk Cymru”, such as “Troedio Clwyd Walks”, improve physical and mental wellbeing, and tackle loneliness, saving NHS Wales money, but Welsh Government funding ends on the 30th September, providing no assurance for the volunteers.
The Welsh Government must provide continuity.
After all, as the Chief Medical Officer for Wales states, “the Social Prescribing Approach can help the management of chronic conditions and decrease demand for health services”.