The Asset-Based Health Inquiry launched last week, investigating how best to develop social prescribing, which NHS England is finally now rolling out. It is designed mainly to shed light on the amazing work that is already happening.
At the heart of supporting people to live good and healthy lives are the need for friends and family, creativity, learning, meaningful activity (hobbies, volunteering), getting out of poverty, navigating the system to get access to services (finances, care, education, health), eating well and being physically and mentally active. No GP appointment can meet this need.
While there is a place for professionals, where people need help coping and navigating, the biggest impact comes from people helping each other. The ambition for social prescribing relies on a multitude of volunteers, co-ordinated by a few volunteer health champions, in turn supported by employed people who nurture, facilitate, develop, ensure probity and governance, and broker funding.
Where the ambition of ‘social prescribing’ works well at scale, it had this mixture of roles.
Perhaps the best three bits of advice we can give, to anyone who wants to start delivering social prescription, is this:
1. Don’t add social prescribing on as another project. There are real people making real connections in the community, and health teams already partnering with communities – and you should start there. Learn from them, grow and spread their approach. We met example after example of great work happening. It might not be in primary care, so lift your eyes and seek out people taking an asset-based approach in local government, and mental health as well.
2. Get out of the way. An asset-based approach generates masses of gifted time, energy, care and compassion. It is not a service. It’s a way of being part of a community: health professionals can take part, but they can’t dictate; they can create the opportunities but then as the patient advocate Alison Cameron says – they need to ‘get out of the way’
3. When it works, this isn’ts not a service add-on; it’s a whole way of relating – redefining roles in the practice and re-shaping the way professional relate too and with people in communities. Where it works, people lived and breathed non-judgmental, purposeful, positive belief in and experience of working with all manner of people trusting their potential. Where it stalled, it was a service provided by professionals to local people.
4. Count friendships. You pay attention to what you count – so what you want more of. We suggest metrics along these lines that get to the heart of the intent of a primary care model of social prescribing:
· Increase in numbers of friends.
· Proliferation of citizen-led not sector-led lifestyle support.
· Primary care ‘coverage’ to touch the whole population in a way that is more fairly and equally distributed.
· Reduced demand on general practice, meeting people’s needs and better overall health.
You can read the report here. The report has four inspiring case studies – The Alvanley Way (Alvanley Family Practice) The Frome Connections (Frome Medical Centre and Health Connections Mendip) Grenfell: After the Fire (you may have seen the fantastic Fatima Elguenuni at NHS TEDx) Wakefield: Dancing Down the Corridors (Creative Minds, West Yorkshire Partnerships Trust).