Welcome and overview. Catherine Wells, Lead Governor, NSFT Gary Page, Chair, NSFT

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2 Welcome and overview Catherine Wells, Lead Governor, NSFT Gary Page, Chair, NSFT

3 Social Prescribing an overview Tim Anfilogoff and Siân Brand East of England Social Prescribing Network

4 Simon Stevens quote: Telegraph 27/12/17 Rather than 'a pill for every ill', social prescribing is a new way of helping certain people get better and stay healthy.

5 Why social prescribing? It s about connecting people for wellbeing Asset-based community development - what s already there build on it Collaborative: everyone around the table, including local authorities, VCSE sector, CCG, primary and secondary care

6 What do we mean by social prescribing? Active Signposting Community Wellbeing Hubs Social Prescribing Connector schemes link workers

7 Social Prescribing Connector Schemes NHS England priority: to enable every local area to commission a social prescribing connector scheme (often hosted in the VCSE sector) Employs link workers, recruits volunteers Gives people time, builds trust, based on what matters to them Develop shared plans connect people with community support Support community groups and assets Takes referrals from all GP practices and other health professionals

8 Most suitable for: People who are lonely or isolated People with long term conditions People who use the NHS the most People with mental health needs Those who struggle to engage with services People with wider social issues: debt, housing, relationships

9 Support with mental health Link workers / connector schemes help and prevent Gloucestershire 75% of people using sp schemes have mental health needs People referred to mental health services great examples emerging of social prescribing alongside existing services (Rotherham, Creative Minds in South West Yorkshire Foundation Trust) Recovery colleges empowers people with mental health problems to become experts in their own recovery NHS England is about to create a development programme in partnership with Defra, to connect people with mental health needs to environmental therapy.

10 Impact Evidence Review Conducted by University of Westminster: Impact of social prescribing on demand for NHS Healthcare. They found an average of 28% less GP consultations and 24% less A&E attendances, where social prescribing connector services are working well. Demand on secondary care services On the person: is their well-being improved? On the community: Are communities stronger as a result? More volunteers?

11 Challenges moving forward Enabling spread with limited funds so that social prescribing connector schemes are in every local authority / CCG area Supporting shared leadership - nurture bottom-up collaborative partnerships We should not assume the voluntary sector is free and always there build in support and funding Building the evidence base everyone measuring the same things so that we can make long-term comparisons We should not over-professionalise social prescribing it s about human relationships putting community and people at the centre

12 Draft Social Prescribing Plan on a Page Aim: To make social prescribing more systematic and equitable, by supporting the spread of local social prescribing connector schemes, which employ link workers, help people around what matters to them and connect them with community support. Increase local connector schemes Build the Evidence Base Help leaders to develop and plan Produce an online resource repository and bite-sized resources Develop a Common Outcomes Framework for Measuring Impact Develop Regional Social Prescribing Networks Work with CCGs to map local SP connector schemes Work with Integrated Care System demonstrator and test sites Support the DH Health and Wellbeing Fund Commission an in-depth Evaluation of Social Prescribing Connector Schemes Put SP codes in General Practice IT Systems Explore whether SP referrals can be the NHS BSA Prescriptions dashboard Support the creation of a Quality Assurance Framework for SP Connector Schemes Work with Defra to support mental health providers to connect people to the environment Develop and pilot learning for link workers

13 Social Prescribing in the news! Guardian Newspaper (21 st February 2018): The town that s found a potent cure for illness community! Frome in Somerset has seen a dramatic fall in emergency hospital admissions since it began a collective project to combat isolation. George Monbiot Daily Mail Newspaper (21 st February 2018): Lonely patients are being 'prescribed' coffee mornings, singing classes and dance lessons to tackle social isolation Sophie Borland

14 Resources Making Sense of Social Prescribing - Guide National Social Prescribing Network socialprescribing@outlook.com NHS England Repository Contributions england.socialprescribing@nhs.net East of England Social Prescribing Facilitators: Tim Anfilogoff Sian Bran tim.anfilogoff@hertsvalleysccg.nhs.uk sianbrand@livingsafeandwell.co.uk

15 Social Prescribing and Community Connectors in Norfolk Rob Cooper Head of Integrated Commissioning (Norfolk County Council and South Norfolk CCG)

16 Vision Access from a range of sources to community based Living Well workers/connectors who help people identify their goals and to make plans to achieve them Link people to expert, specialist help and support to resolve issues which negatively impact on their ability to stay healthy, manage their health conditions and live independently. Help identify appropriate community assets and connect people with communities Consistent core service at scale for people wherever they live across Norfolk and Waveney Priority for the Norfolk and Waveney STP

17 Key principles Combines consistent approach with local delivery and flexibility Delivered at scale, accessible to patients from all GP practices across Norfolk and Waveney and accessible through other routes One approach to evaluation built in from the start Asset based utilise existing resources, including those from Local Authorities and existing community groups and voluntary sector Makes sense can be clearly understood by people who could benefit and organisations who can help people to access and links rather than duplicates what is available in a local area. Founded on partnership with voluntary sector and district councils, acknowledging their expertise in this area, building on learning and enthusiasm from current projects

18 Building on current community assets and initiatives Current social prescribing initiatives LILY (older people in West Norfolk); South Norfolk Connectors; GP led approaches and Neighbourhoods that work in Great Yarmouth; CAB pilot in Tuckswood and Lakenham Early help hubs Integrated Care Coordinators Adult Social Care Development Workers Norfolk Libraries projects Many current Voluntary Sector and community initiatives Support for people who are lonely and isolated

19 Model supports the innovation social work pilots for Norfolk Living Well 3 conversations Based on method developed by Partners for Change 3 conversations Conversation 1 Listen hard and connect Understand what really matters to the person. Connect them with resources Conversation 2 Work intensively with people in crisis What needs to change urgently to help someone regain control of their life. Conversation 3 Build a good life What does a good life look like? What assets, strengths, resources (including people with personal budgets) does someone have to support their chosen life? This approach moves away from the assessment and care package model of social work. It depends on social workers, occupational therapists and social care staff spending more time with individuals and builds on existing strengths-based approaches adopted by NCC, encouraging social care professionals to connect with the networks and support available in local neighbourhoods and communities.

20 Work Programme - 950k per year investment for 2 years Funding for connectors and some funding for community activities and assets. July 2017 Sept 2017: Explore model and options for delivery with wide range of stakeholders. Sept 2017 Oct 2018: Establish locality planning groups (key partners District Councils, CCGs, Voluntary organisations, Adult social care, GPs), agree detailed delivery model for each locality; source providers; establish grant agreements with providers; recruit to Connector roles; develop detailed implementation plan with clarity about how connectors will work with existing crossover roles; develop and implement strong communication plan; services start; agree governance and implementation of local community funding pots; design joint training. Sept 2017 May 2018: Design and establish evaluation framework; develop a detailed business case for Social Investment Bond to be used as a vehicle for some future investment in the model. June/July 2018: Official launch. July 2018 March 2020: Continue to develop, review, adjust, report, evaluate, recommend, sustain where successful (ie Social Investment Bond)

21 Locality / local models lead providers Who will provide the connectors in each locality? North Norfolk North Norfolk District Council Norwich and Broadland Advice led model with 5 advice organisations providing the connectors through Norfolk Community Advice Network South Norfolk South Norfolk District Council Breckland and West Norfolk A range of VCS providers through Community Action Norfolk Great Yarmouth A number of VCS providers through Great Yarmouth Borough Council

22 Who will the Connectors work with? Public Health - What influences quality of life, health and wellbeing What is the potential impact of not preventing and/or addressing certain problems or not intervening early enough (preventable disease, physical conditions, self esteem and bullying, problems that may not present until adulthood)? Health Inequalities support programme ce/dh_115113

23 Possible impacts - health Reduction in the proportion of GP appointments that are not directly related to health conditions and which could better be addressed through alternative providers. Reduction in the average number of GP appointments among the cohort of patients referred to the wellbeing advisor/connector service. Decrease in the number of hospital admissions (inpatient days) among the cohort of patients referred to the wellbeing advisor/connector service, 12 months following referral. Reduction in use of 999, accident and emergency attendances among the cohort of patients referred to the wellbeing advisor/connector service? Reduction in the number of outpatient appointments among the cohort of patients referred to the wellbeing advisor/connector service. Reduction in prescribing of antidepressants to patients referred to the wellbeing advisor/connector service. People feel better about themselves and report improvements in wellbeing

24 Possible impacts - social care Improved customer experience with people telling their story once Increase in the number of people who are able to remain independent for longer Reduction in number and costs of formal packages of support (preventing or delaying the need for some packages) Average home care package for an older person in Norfolk is 9,189 per year. A six month delay would therefore generate a prevention saving of 4,595 per year. If 5% of packages (260 individuals) were delayed the saving would be c 1,194m Improved wellbeing for people receiving targeted information, advice and support (currently around 10,000 people a year) Improved effectiveness of NCC s front door service in finding solutions for people using information and advice Reduction in the number of assessments that only result in the provision of information and advice (because information and advice is provided more effectively)

25 Community Resilience & Social Prescribing: Colin Baldwin; Suffolk County Council

26 Social Prescribing is one approach by which we are seeking to deliver our vision of community resilience. Our SP modelling has been influenced by; 5WTWB RtV National SP Model Community Resilience and the Five Ways to Wellbeing

27 Our work around community resilience, particularly that within social prescribing seeks to follow much of the principles and approaches espoused within Realising the Value. Realising the Value was a programme funded by NHS England to support the NHS Five Year Forward View.

28 Our thinking in the development of a Social Prescribing Plus model derives from the National SP Model (see link below) and then widening it to site within a wider asset and locality based early intervention and prevention model /Making-sense-of-social-prescribing% pdf

29 Social Prescribing Core elements & SP+ Social Prescribing + (Community Connector)...taking services to people

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31 Kerrie Gallagher Mind, Body and Soul Health and recovery through social prescribing

32 Building on existing foundations: The South Norfolk Help Hub Help to residents at the earliest opportunity Reducing the opportunity for crisis and increasing self-help This is an approach to how we work together not just about a physical working space Base in Long Stratton a space for organisations to work Single point for request for support

33 What do Community Connectors do? Based and operating within local communities; they help people to: Be part of their community Have positive relationships Gain skills and feel confident Have a warm and safe home Be free from money worries. They do this by listening and connecting people to the right places and people

34 What is Social Prescribing? Social prescribing schemes: Offer a non-medical solution to issues that may be causing or exacerbating health problems of patients Are simple and easy for patients, and professionals to understand and benefit from Are not in themselves a support service The service aims to be very much communityrooted

35 The Perfect Partnering

36 What does it look like?

37 Where are we operating?

38 How things are shaping up

39 Customer Perspective

40 Any questions please come and speak to us!

41 Haverhill LifeLink Lizzi Cocker Elaine Hewes

42 Haverhill LifeLink

43 Haverhill LifeLink Model

44 What we ve learned so far Male Female

45 Continued. PARTNER REFERRALS Advice/Finance Social Groups Volunteering Active Statutory services Support Groups Mental Health Support (VCS) Employability Employability 3% Mental Health Support (VCS) 18% Advice/Finance 29% Support Groups 7% Statutory services 7% Active 3% Volunteering 8% Social Groups 25%

46 Next steps Continual development with community groups and activities Develop work with Department for Work & Pensions Establish evidence to show reduced demand on health and statutory services Work with partners to develop place based social prescribing projects for West Suffolk!

47 Any Questions?

48 Which came first? Amanda Green

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50 I, and those around me, must learn to live alongside my symptoms!

51 Recovery means building a meaningful and satisfying life whether or not I have on-going symptoms of mental illness

52 a) Do we reduce symptoms before we start to do meaningful activity? b) Does doing meaningful activity reduce symptoms?

53 NSFT Recovery Strategy: Priority Goal One Recovery at the core of every conversation

54 I am useless, worthless I helped someone today at work

55 I can t do anything I m studying for my MSc

56 I wish I was dead I haven t finished everything I want to do yet

57 To reduce my risk of suicide and self-harm Support me to build a meaningful life and have reasons to live!

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59 Question time

60 Break and refreshments

61 Workshops Direct support Green therapy Arts, crafts and other interests Food and diet Sports and exercise Soul

62 Networks for Social Prescribing

63 Is this what public services do? If you want to get somebody to do something, make it easy. If you want to get people to eat healthier foods, then put healthier foods in the cafeteria, and make them easier to find, and make them taste better. So in every meeting I say, Make it easy. Richard Thaler, Economics, Nobel Laureate 2017

64 We All Need Networks There is support out there & it is getting easier to find Both for the individual in the community and for the staff member Just as important to connect people in organisations to each other Rich tapestry of experience & good practice to share both in communities and beyond geographical boundaries Asset based, community up approaches, link worker roles, are key and strength based conversations

65 We All Need Networks For example 1,600 contacts to HertsHelp per month In May 2017 triaged people to 140 different organisations Community Navigators provide HertsHelp information face to face to people who need more support/motivation (nudge?)

66 We All Need Networks For example Over 170 organisations on website and 380 different activities to refer to Google Analytics - January 2016 to October ,770 page views & 32,547 sessions & 2m56s average session Trained over 500 Connect Well Champions in social prescribing and MECC to have a different conversation with people and lead empowered signposting Self-refer public launched on International Day of Happiness

67 Embedding SP in the system Citizen No wrong door GP Social Prescribing Scheme Social Prescribing Scheme Link Worker Role/Care Navigator Social Care Social Prescribing Scheme Other (voluntaries, housing, Council, pharmacy etc) Co-production of a bespoke package of support and community links that the person wants

68 Social Prescribers are not Alone! 1,300+ members 300+ projects NHSE support National Clinical Champion for Social Prescribing Dr Michael Dixon Regional leads East of England Tim and Siân Parliamentary launch March 2016 (Dr Michael Dixon co-chair of NSPN left, Dr Marie Polley of Westminster University right, pictured with then Care Minister, Alistair Burt MP)

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70 Evaluation Data A review of the evidence assessing impact of social prescribing on healthcare demand and cost implications Polley, M., Bertotti, M., Kimberlee, R., Pilkington, K., and Refsum, C. Share your evaluations to build the national SP evidence base

71 Nobel Prize material? I had a lady that was invited to a breast screening, who refused to go. So I offered to go with her, and waited with her in the waiting room. Now I know that next time she is invited she ll go because she ll know what to expect, because it s not the frightening thing that she thought it was. Community Navigator I picked her up and took her and on the way back she said I never would have done that if you hadn t taken me.that exercise group had left her a leaflet, but she wasn t motivated enough to do it by herself. Community Navigator

72 East of England Regional Plan Help CCGs fill in NHSE questionnaires Two conferences per year (next one in June after international evaluation conference, Salford) Set up new Steering Group STP regional master class on Social Prescribing Helping network members support each other Share regional examples of schemes and good practice

73 Get in touch Tim Anfilogoff - Tim.Anfilogoff@hertsvalleysccg.nhs.uk Siân Brand sianbrand@livingsafeandwell.co.uk THANK YOU

74 Closing comments Nigel Boldero, Public Governor, NSFT

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