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What is Social Prescribing? And what is the Ten Year Forward Plan for the NHS

What is Social Prescribing? And what is the Ten Year Forward Plan for the NHS. Dr Richard Kimberlee University of the West of England, Bristol Social Prescribing Network South West NHSE Regional Facilitator. Average GP appointment times (Duncan 2016). Symphony integrated care models.

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What is Social Prescribing? And what is the Ten Year Forward Plan for the NHS

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  1. What is Social Prescribing? And what is the Ten Year Forward Plan for the NHS Dr Richard Kimberlee University of the West of England, Bristol Social Prescribing Network South West NHSE Regional Facilitator

  2. Average GP appointment times (Duncan 2016)

  3. Symphony integrated care models % of population % of cost Complex care/extensivist Complex patients with many conditions ~50%~£75m 4% ~5k Shared care 18% ~20k Less complex patients with fewer conditions Enhanced primary care ~35%~£55m 78% ~90k Mainly healthy patients ~15% ~£20m Proactive health and wellbeing support

  4. Crisis in Primary Care • Aging population • Increase in the burden of mental health • Increase in long term conditions • Higher expectations as consumers • The collapse of the Universal welfare state • Pharmacological

  5. What is social prescribing?

  6. “There is a growing evidence base that social prescribing can be better for patients than medicine. Of course there will also be medicine prescribed – and rightly so – but I want to see the balance shifted in favour of social prescribing ………………The nature of social prescribing is that what you’re prescribing is a social activity, so of course, anybody can suggest to somebody that they do a social activity. My wife regularly tells me to do more exercise. But what I really care about is ensuring that within the NHS it is normal practice to consider a formal social prescription and that the growing evidence base for the value of social prescribing is taken on board by practitioners,” Matt Hancock (2018) Speaking at NHS Expo in Manchester

  7. Social Prescribing Network

  8. Who funds social prescribing?

  9. Impact of social prescribing • 28% reduction in demand for GP services (2-70%) • 24% fall in A and E attendance (8-26%) • Fall in A and E emergency admissions (6% , 7% and 33.6%) • Drop in secondary care referrals at 12 months (55%) and 18 months (64%)

  10. Return on Investment • Estimates varied widely from a Return on Investment (ROI) of 0.33 annually to a return of £11 per patient per £1 per annum . • The average (Social) ROI was £2.3 per £1 invested in the first year.

  11. NHSE/SPN Common Assessment Framework

  12. Long Term Plan commitments • 1.39. We will roll out the NHS Personalised Care model across the country, reaching 2.5 million people by 2023/24 and then aiming to double that again within a decade. • 1.40. As part of this work, through social prescribing the range of support available to people will widen, diversify and become accessible across the country. Link workers within primary care networks will work with people to develop tailored plans and connect them to local groups and support services. Over 1,000 trained social prescribing link workers will be in place by the end of 2020/21 rising further by 2023/24, with the aim that over 900,000 people are able to be referred to social prescribing schemes by then.

  13. Five Year Framework for GP Contract Reform • NHS England will provide funding directly to primary care networks (PCNs) for a new, additionalsocial prescribing link worker to be embedded within every PCN multi-disciplinary team, through the Network Contract Direct Enhanced Service (DES). • Starting from July 2019, at 100% reimbursement of the actual on-going salary costs, up to a maximum amount (£34,113) GP Contract Reform, section 1.26. The percentage will neither taper nor increase during the next 5 years, giving networks maximum confidence to recruit to the full. • Existing practice suggests that many PCNs may choose to fund a local voluntary sector organisation to employ the link workers on behalf of the network. The contractual arrangement will be for local areas to decide, but the funding will be routed via the Network Contract DES. • Funding will also be available to all PCNs across England, including local areas where link workers are already embedded in primary care multi-disciplinary teams.

  14. How can local partners maximise this funding opportunity? CCGs will be encouraged to bring local partners together to develop a shared local plan for social prescribing, incl. local authorities, primary care networks, VCSE leaders, existing social prescribing connector schemes and other partners. Plans should include: • how partners will build on existing local social prescribing connector schemes to avoid duplication and maximise impact • how social prescribing link workers will be embedded in all primary care networks across the local area • how additional link workers will be recruited locally • shared commitment to support for the VCSE sector and community groups to receive social prescribing referrals, through funding and development support. Templates are available from NHS England: england.socialprescribing@nhs.net

  15. Personalised Health Budgets • NHS England and Improvement show 54,143 people with long-term health problems are currently benefiting from them. • At least 200,000 people will be given the chance to improve their health and wellbeing by using a Personal Health Budgets within the next five years. • The majority of Personal Health Budget spending goes on the provision of direct care and support, eg help with washing, eating, dressing and other aspects of essential personal care. • May also oster investment in new technology, with patients able to request modified and improved support like personalised wheelchairs. • Many patients with chronic conditions, like arthritis and serious muscle problems, have hired personal assistants who can help to manage household tasks and ease pressure on joints, stopping problems escalating and leading to intensive medical treatment or the need for going in to a care home or being admitted to hospital. • Could be used to buy into social prescribing!

  16. SPN South West: Bristol 23rd October 2019 20th February 2020 Regional Social Prescribing Network (South West) conference July 2020 International Social Prescribing Network Conference • CCG/STP Learning Events for new link workers. • @SocialPresHour (Wednesday 2000)

  17. Please feel free to contact Richard Kimberlee richard.kimberlee@uwe.ac.uk Tel:07946189086 Twitter: @Albion38 What is social prescribing? http://scholarpublishing.org/index.php/ASSRJ/article/view/808 What is the value of social prescribing? http://www.scholarpublishing.org/index.php/ASSRJ/article/view/1889 Whither social prescribing? https://staging.bhma.org/product/social-prescribing/

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