Exploring Social Prescribing in Sheffield

1. AGENDA

2. Social Prescribing in Sheffield Emma Dickinson Sheffield City Council

3. What is Social Prescribing? , the social model of health – this is the perceived view of SPx … – it is also about … .

4. NHSE Definition of SPx • Social prescribing is a way for local agencies to refer people to a link worker. Link workers give people time, focusing on ‘what matters to me’ and taking a holistic approach to people’s health and wellbeing. • They connect people to community groups and statutory services for practical and emotional support • In Sheffield, we understand SPx to be more than just ‘connecting’ – importantly it is more about: • Making friends and developing purpose and confidence • Enabling people to resolve life problems

5. SPx – nothing new in Sheffield • Today is about an opportunity to understand how you might use this additional resource to complement what already exists • You may know it as; People Keeping Well, Health Trainers, Community Health Champions, Community Support Workers • The Sheffield Model is not ‘one size fits all’ but is flexible, responsive and built locally in the Neighbourhood • BUT they use the following key principles …

6. Social Prescribing in Sheffield – if we were to draw a picture… Council staff e.g. housing, communities, social care • Advocacy support • Advice on housing, health, social care • Support to check benefit entitlements and complete forms • Carers Life admin District Nurse / Occupational Therapist • Health Trainer / coach • Encouragement to live an active life • Smoking cessation • Healthy weight • Chronic pain groups • Managing long term conditions • Self-care People Keeping Well – local VCF organisation Healthy lifestyles GP • Activities • Craft, knitting, social groups, gardening • Dementia cafes, carers groups, sporting memories • Cooking and food groups • Health walks, exercise sessions VCF Activities Family / friend / self 5 Ways to Wellbeing

7. Social PrescribingNavigating the NHSE model – a support guide for Primary Care Networks Adapted from : SY&B Social Prescribing Steering Group, April 2019 Dr Anthony Gore and Yvonne Elliott

8. Framework for General Practice Contract The new Framework for General Practice notes that: • By 2024, social prescribing link workers will have become an integral part of the core general practice model. • As part of the Primary Care Network DES, PCNs will have to deliver a national service specification for personalised care (including social prescribing). • Minimum activity levels will increase gradually over time. Both the complex care and personalised care service specifications commence in 2020/21 with requirements and expectations increasing over the following three years in line with workforce expansion. • Many networks may choose to fund a local voluntary sector organisation to employ the link workers and run the service of behalf of the network.

9. Reimbursement Scheme • Starts 1 July 2019, reviewed after five years. • Estimated 20,000+ additional posts in five specific different primary care roles. - 2019 - Clinical Pharmacists and Social Prescribing Link Workers. • 100% of the actual ongoing salary costs and on costs for social prescribing link workers is reimbursable up to band 5 Agenda for Change pay scale (£34,113 including on costs, 2019/20). • Additional people only. A baseline survey of current link workers will be carried out in May. • No specific NHSE funding has been announced so far to cover other costs e.g. training, travel. (approximately additional 20-30% of the salary and on costs). • The scheme also doesn’t include funding to cover the costs of onward referrals from link workers to community groups.

10. Potential Hosting Options • Link workers employed, supervised and managed by PCN. • PCN sub-contracts existing social prescribing services to undertake extra activity and increase their number of link workers. Link workers part of PCN multidisciplinary team but employed by Social Prescribing provider. • Additional link workers employed by PCN host organisation and seconded to the existing social prescribing service. • Additional link workers employed by existing SP services and seconded to PCNs. • PCN sub-contracts provision of the additional link worker activity to another provider e.g. GP Federations.

11. Social Prescribing Link Worker Role Key responsibilities from the draft job description: • Take referrals from a wide range of agencies. • Provide personalised support to individuals, their families and carers to take control of their wellbeing, live independently and improve their health outcomes. • Draw on and increase the strengths and capacities of local communities, enabling local VCSE organisations and community groups to receive social prescribing referrals. • Work collectively with all local partners to ensure that local VCSE organisations and community groups are sustainable and that community assets are nurtured.

12. Predicted KPIs The new specification is likely to require PCNs to deliver the following KPIs: Primary Care Networks will be monitored via a primary care network dashboard that indicates comparative performance.

13. Care Navigation and Social Prescribing Link Workers • Both Care Navigation and Social Prescribing: • Look beyond the presenting ‘issue’/request • Present alternatives to a clinical intervention, including social alternatives • Reduce avoidable GP appointments - care navigation diverts people from a GP appointment in the first instance to a more suitable alternative, social prescribing may reduce unnecessary repeat presentations from the same person. • But, fundamentally different: • Purpose • Type of intervention • The person i.e. attributes, skills, motivation • Training • Base of operation • Knowledge/relationship with community services.

14. Additional Considerations SY&B engagement identified emerging themes from stakeholders: • Current social prescribing schemes are well regarded. • Current unmet need and great potential for future expansion. • Key patient cohort and referral pathways to develop. • Children and young people. • Social prescribing link worker activity cannot keep increasing without concurrent investment in the services that they refer people on to (particularly voluntary sector). • How the voluntary sector can support people when developing all relevant care pathways.

15. Social Prescribing Joint Learning NetworkHow We Are Working Together: PCN & Neighbourhood VCS Organisation Guy Weston (Health Services Manager- SOAR) Maddy Wood (GP Neighbourhood Coordinator- SAPA and North2)

16. 1. Our Approach (the basics): • Reaffirming an existing relationship • Being open minded about perceptions of SOAR • Positioning & utilising existing assets • Joint discussions (& encouraging wider involvement) • Managing expectations.

17. 2. Key components of a neighbourhood VCS Organisation What can a neighbourhood VCS organisation (of size and maturity) offer a PCN?

18. 3. Key Actions: • Face to face meetings • Nature of the contract- Full cost recovery, VAT • How to evolve the Social Prescribing system • Consistent approach • Sharing information- challenges and successes across the PCNs/North locality/City.

19. 4. Contact: Guy Weston: guy.weston@soarcommunity.org.uk Maddy Wood: maddy.wood@soarcommunity.org.uk Tel. 0114 213 4065

20. Table Discussions Based on what you have heard today discuss how you think PCNs should approach the role of Social Prescribing to support Primary Care Networks in Sheffield as part of the new Network Contract DES