It is scarcely believable that only 20 months ago, primary care networks (PCN) had not yet seen the light of day. So much water has passed under the bridge since then and yet so much has been achieved in the transformation of primary care despite the system and the country having to cope with a pandemic for nine of those months.
The NHS Long Term Plan, published in March 2019 was truly transformational, introducing and embedding in the system the concepts of the PCN, personalised care and the role of the social prescribing link worker (SPLW). All three concepts are now well established and in the last year the vast majority of PCNs have taken advantage of the additional roles reimbursement scheme (ARRS) to recruit their first social prescriber.
The introduction of the SPLW to help patients address their underlying health and wellbeing issues was not a new concept – it has been common in the voluntary sector under various guises and job titles for many years, but its formalisation in the Long Term Plan has made NHS-wide adoption pretty much universal.
There were of course not 1,000 social prescribers sitting around waiting to be recruited, so posts were filled from other caring professions, some of whom had experience of similar roles in the voluntary sector whilst others just shared a passion for wanting to help people. Nor were GPs 100% supportive. Some were sceptical about the need for the role in the first place, while others simply didn’t have enough time to consider how they might employ their social prescriber, and left recruitment and deployment decisions to the clinical director.
Over the last year and a half however, and particularly during the lockdown period, social prescribers more than proved their worth. Scepticism has largely ebbed away, as the versatility and flexibility of the SPLW became
clear, and social prescribers took it upon themselves to carve out a niche for themselves as essential and valuable assets in the PCN’s multi-disciplinary team.
In February this year, the success of PCNs and social prescribers was recognised and endorsed when the update to the PCN directed enhanced service (DES) provided 100% funding to PCNs for the recruitment of an additional eleven allied health professional (AHP) roles. Two of these, the health and wellbeing coach, and the care coordinator have been specifically added to bolster the size and capability of the PCN’s social prescribing team.
The way in which PCNs have employed these additional roles has varied according to the needs and circumstances of each PCN. Some care coordinators are working with care home residents as part of the new PCN enhanced health in care homes requirement, whilst health coaches, in addition to maintaining a link worker caseload, work additionally with those patients with multiple and complex issues. These patients can often benefit from a health coaching approach to help them take greater control over their own health and wellbeing.
What is increasingly clear, is that with the additional roles available, the default model of allocating a social prescriber’s time evenly across the number of practices in the PCN is no longer logical or efficient, if indeed it ever was. The emergence of Social Prescribing Hubs, often introduced in response to COVID restraints on face to face consultations, have proved highly effective. Patient referrals are taken from across the PCN’s member practices, triaged for priority and then allocated to the most appropriate member of the social prescribing team. The hub model allows for many more patient consultations to take place, with the right link worker for the patient’s needs, and with the minimum of delay and double handling.
Since July this year PCC’s SocialPrescriberPlus programme, which is the first social prescribing training programme in the country to be accredited by the new Personalised Care Institute, has been equipping new and recently joined social prescribers, care coordinators and health coaches for success in these new roles.
Comprising three half day workshops, SocialPrescriberPlus is a comprehensive and practical programme that equips delegates for success, whether they are supporting primary care in a PCN or operating in the community.
The first workshop covers everything the link worker needs to operate effectively within a PCN or practice – building productive and professional relationships with practice and PCN leaders and colleagues, as well as with the many community and voluntary groups to which the link worker will signpost their patients. It includes an introduction to personalised care, how to engage patients effectively and build rapport and trust, and provides approaches and templates to enable link workers to identify ‘what matters’ to the patient.
The second workshop covers the key techniques and approaches used by link workers, including active listening, motivational interviewing and health coaching. It covers NHS reporting requirements, patient evaluation measures such as the PAM and ONS4 and guidance on creating a directory of services.
The third workshop is a reflective practice, active learning and networking session that provides a forum for the link worker and their colleagues to come together and discuss case studies and challenging situations. The session encourages resilience and provides a vehicle for further networking and the building of a community of practice in which most delegates are keen to participate.
Nick Sharples is a PCC associate and highly experienced social prescribing lead. He facilitates PCC’s SocialPrescriberPlus programme and is passionate about the many benefits that Social Prescribing can bring to patients and to the wider community. Nick also runs training programmes in care navigation and active signposting, digital group consultations and health coaching for social prescribing team members.
Book a place on the next SocialPrescriberPlus programme. If you would like a programme run locally for your social prescribing team or you are interested in any of the other programmes Nick runs contact firstname.lastname@example.org