Social prescribing, as described by the NHS and others, links people with health problems into practical and emotional support in communities and the voluntary sector. Overall it seeks to address people’s needs in a holistic way and support individuals to take greater control of their own health and wellbeing. This can be done in different ways but many approaches involve link workers or ‘connectors’ (who work with people to identify which practical, emotional and community support can best help them achieve their goals) as well as ‘builders’ (who work within communities to ensure relevant support is available locally to meet people’s needs).
In parts of Somerset there are already some successful social prescribing projects which have improved people’s lives and are contributing to the development of stronger communities. Building on this a cross-sector group of partners  have been working together over the past year to explore how to spread more of this activity equitably across the county.
Research and development was supported by grants from the Life Chances Fund and South West Academic Health Science Network alongside ongoing in-kind investment from the Richmond Group of Charities, the Somerset Sustainability and Transformation Plan and Somerset Voluntary Community and Social Enterprise Strategic Forum.
Research and development took place over the period Oct 2017 to April 2018. There were three strands of work in this Development Phase:
- A community research exercise, which focused on exploring the issues that are important to people, professionals and communities in the design process. The process used local community researchers and included a GP survey. Over 200 people and professionals were involved in the process.
- An evidence review conducted by the University of West England, which focused on understanding evidence and best practice in a number of social prescribing approaches across Somerset and Devon, and further afield.
- Data modelling and financial feasibility testing, conducted by OPM (now Traverse), which brought together the findings from the first two strands of work with data modelling and financial feasibility testing of different approaches, including an outcomes based contract backed by social investors.
The research found that social prescribing is an important element of the health and care system in Somerset. It creates good outcomes for people that reduce dependence on statutory services and there is evidence to support the spread of the approach sustainably and equitably across Somerset. It confirmed that there is good practice that can be built on if certain conditions are in place, notably investment in community development and infrastructure, and professionals are engaged. The research also concluded that taking a one-size fits all approach to social prescribing is not appropriate for Somerset and that locally owned and delivered models need to be developed which include the five key principles of ‘good’ social prescribing:
- Person-centred – with conversations focused on, and connections made to community based solutions that are based on a person’s strengths and personal goals;
- Community-building – with attention given to building on existing assets, generating social capital and local responses to fill gaps with ‘good stuff we know works’;
- Collaborative working and communication within and between sectors – with skilled link workers that take an asset-based strength building approach to connect people into personal and community networks as well as the practical and emotional support within communities and the voluntary sector;
- Buy-in from referring professionals; and
- Sustainable funding (for both infrastructure and provision of ‘good stuff’ in communities where needed.)
The potential for using an outcomes-based contract backed by social investors to develop and fund social prescribing was explored.
While this approach to financing was judged to be feasible, commissioners felt the work would be better mainstreamed and pursued through the new Somerset Health and Care Strategy. On this basis, the project partners did not apply to the next stage of the Life Chances Fund.
The work undertaken since the initial grant was made will now feed into, and help drive, Somerset’s new Health and Social Care strategy, Fit for My Future, going forward. With the remaining grant funding, work will continue with the local voluntary and community sector to explore the gaps and opportunities for enabling local development and delivery of social prescribing in the areas where it does not yet exist. At the same time, work will be undertaken through the strategy to develop a county-wide framework to ensure equity of access, quality assurance and a shared approach to evaluation and monitoring. This Design Phase will continue throughout the rest of 2018.
In the Design Phase two tracks of work are now underway. First through the Health and Care Strategy, which will be going out to public engagement later this year on a set of proposals. Second through more detailed design with citizens, communities, professionals and the voluntary sector to identify what gaps can be filled through greater coordination and where investment is required in community infrastructure, activities and support. The Strategic Forum will be coordinating this aspect of the work with the local Voluntary, Community and Social Enterprise sector in partnership with the Richmond Group. An update outlining next steps and ways to be involved will be given at the next meeting of the Strategic Forum.
The aim is that this work will be completed in line with the Health and Care Strategy timeline. High-level proposals will be submitted in July 2018, followed by more detailed design to develop and strengthen the approach for spreading social prescribing equitably and sustainably in 2019.