Nehal Depani, NCVO (originally posted February 2015)
What does the voluntary, community and social enterprise sector’s contribution to health and wellbeing look like? Of course, there are tens of thousands of voluntary organisations doing great work directly linked to health and social care – from helping with activities in care homes to carrying out medical research. But an individual’s wider lifestyle and their personal circumstances also have a huge impact on their health and wellbeing. So it’s important not to forget about the contribution made by those voluntary organisations working in other areas – be it housing, advice, arts and culture or something else.
Social prescribing is a great example of a way in which these organisations can maximise their contribution to health and wellbeing. But what exactly is social prescribing, and what wider lessons about the sector can we draw from it?
What’s the medicine?
Social prescribing simply means a programme which links patients to non-medical support in their community. Individuals might be suitable for social prescribing if, for instance, they have a chronic physical or mental health problem or they belong to a group which is particularly at risk, such as a recently bereaved older person or a newly arrived immigrant.
Social prescribing is about recognising that a number of social and economic factors – isolation, an inactive lifestyle, benefits and debt issues – impact on the health and wellbeing of individuals. Busy health care professionals do not necessarily have the resources or expertise to tackle these issues, so social prescribing draws on the wider community.
Social prescribing comes in many shapes and sizes. The activities offered differ according to what’s available and the target patient group, but can include gardening and horticulture, formal education, creative activities, weight loss and exercise programmes and advice and information. So for instance, “Creative Alternatives” in Sefton offers creative activities to people experiencing mild to moderate depression, stress or anxiety, and has been operating since 2006.
There’s also a range of models of how social prescribing works in practice, including who can refer patients, the mix of one-to-one and online support and monitoring and evaluation systems.
Many of the activities that are likely to be prescribed under this system are will often be run by voluntary organisations for their local community. As a result, social prescribing offers a number of opportunities for these organisations to take advantage of.
An ounce of prevention is worth a pound of cure
People with happy and active social lives have better health than people who don’t. The evidence in this area is stark – one study found that subjective well-being increases life expectancy by seven and half years.
Of course the needs in each particular case will vary – some people will benefit from meeting new people in a stimulating environment, while others want to gain new skills or access advice in a particular area. In all cases though, social prescribing has the potential to empower individuals to make choices that give them more control over their own health.
And what’s good for individuals is good for the system as a whole. Offering interventions when people are struggling to cope with long term illnesses or are at a particularly difficult point in their life means that person is less likely to have to rely on expensive care at a later stage. This helps the appropriate allocation of limited healthcare resources.
As a matter of course, social prescribing brings together a wide variety of different organisations that need to work in partnership to achieve the health and wellbeing outcomes they’re aiming for. This extends beyond local voluntary sector infrastructure and the local authority and will likely include others whose work is relevant to public health: CCGs, individual GPs, colleges and local businesses as well as community groups and smaller local charities.
Unlocking the potential of social prescribing is dependent on productive relationships which bring together old and new partners. This means ensuring that the relevant organisations know and trust each other – simple enough in theory, but often trickier in practice. The Compact is one of the tools that can help this process.
What are the lessons?
As the review into the voluntary sector’s contribution to health and wellbeing gets underway, now is a good time to think about what lessons we can learn from social prescribing.
Firstly – the voluntary sector is absolutely integral to ensuring the wider good health of the community. We are more connected with marginalised communities and have the expertise to tackle the wider social and economic factors which impact on health.
Secondly – we can provide value for money for government in the long run. By thinking creatively, the sector can help people and relieve pressure on public services in a tough economic climate.
And thirdly – if the sector is to fulfil its potential, thought needs to be put into how partnerships with government work in practice. How can we ensure that the right people are not only in the same room, but trust and respect each other enough to form the productive relationships we need?
Where can I find out more about social prescribing?
– BigAssist online discussion on social prescribing
– RAISE, “Social prescribing: A RAISE briefing paper”
– Age Concern Yorkshire & Humber, “Social prescribing: A model for partnership working between primary care and the voluntary sector”
– Sheffield Hallam University, “Emerging lessons from the Rotherham social prescribing pilot”
– Nesta “More than just medicine: new services for people powered health”
On Social Prescribing – Nehal Depani NCVO with references