Social prescribing link worker: 3 things primary care networks should do to increase successful delivery

Social prescribing is a win win situation for primary care networks and their local population. Supported and resilient link workers are a trusted resource that can help general practice to help their patients with non-clinical needs, allowing GPs to focus on what they can do – their patients’ clinical needs. Link workers are an integral part of the primary care network team, delivering holistic service to patients and improving the health of the local population.

3 things primary care networks should do to increase successful delivery:

  1. Ensure the link worker’s role is interpreted same way not only in primary care but across the STP and nationally
  2. Ensure the link worker’s role is embedded in local workforce transformation and integrated care approaches
  3. Ensure link workers training is not disjointed but based on the link worker competency framework

 

This will ensure efficiency and consistency which will yield higher return on investment and patient experience.

The 1st ever national social prescribing link worker success conference holds on 8th July.

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Get involved: top tips for social prescribing day

Social prescribing is a key part of the NHS long term plan and universal personalised care. It is a way of enabling people to have access to the right support for their wellbeing and social needs through referral to a listening and non-judgemental expert called a link worker; who listens to what matters to them in order to help them identify their own solutions. Save the date, 8th July is #linkworkerday19, a day to celebrate link workers- A.KA listening experts.

March 14 is a day to raise public awareness of social prescribing. Whether you an individual or an organisation, you can do something to raise awareness within your network and community.

Here are 5 ideas to get involved:

Get involved on social media using #socialprescribingday

Give free talks at community events or within your network

Host online/in person live events. You can do this yourself or in partnership with others

Hold an Information stall

Create and distribute pamphlets

Examples of where to raise awareness:

Libraries

Social media

Local newspapers and radio

Your network (friends, family, colleagues )

Local community groups

Schools

Sports club/Gym/ leisure centres

Local businesses/organisations

GP surgeries

Hospitals

Newsletters

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For further information
Social prescribing day

NHS England

Link worker network

National Association of Link Workers response to universal personalised care

We welcome the universal comprehensive care implementation model as it demonstrates a radical shift from the status quo. Having been co-produced with patients and communities. Finally, the NHS recognises that its role is to facilitate, enable patients and communities (the experts) to come up with solutions to their concerns and to not dictate the solutions. The delivery challenge would be to ensure that this power shift is sustained and continues to be the case. As ever, we are committed to collaborating with partners to support link workers who are the new workforce at the heart of the universal personalised care delivery.

Our link worker members are listening experts’ who help build people’s resilience and capability to take control of their health and wellbeing. They enable people have access to support for their holistic needs and facilitate social inclusiveness by listening to them. This role is highly complex; it requires robust link worker support provision, on the job learning and evidence of continuous professional development. As patients listening experts,  the link worker community of practice expect same; to be listened to, not to be professionally excluded and to be supported in order to help others; this is the reason for our existence as an association.

Link workers are the only workforce across health and social care whose dedicated job is largely to listen to what matters to people. Therefore, if someone is not good at listening to people stories or isn’t approachable, a link worker’s  job will be inappropriate regardless of professional qualifications and accreditations. Here is what a current link worker said

“In order for me to have a good relationship with my client that I am working with they need to feel comfortable talking to me. It makes no difference how skilled I am or how willing the client is to engage, if they don’t feel comfortable working with me, talking to me, or sharing their problems with me then I am not likely to be very successful in keeping them engaged and completing any tasks that have been identified for support”

With the increased interest in the link worker role and the fact that it is not a regulated profession, it is crucial that the essence of the role and social prescribing is preserved; which is a dedicated person to listen to what matters to patients, enabling them have access to their solutions and facilitating social connectedness.  This is the reason the over 1000 new link workers need to join their peers inorder to reduce risk of inconsistencies in professional standards across the country and to be supported .

If social prescribing is designed correctly, it will mainstream joined up care once & for all, which will be good for patients and the health and social care system. Therefore, we would expect local delivery teams to co-produce effective patient pathways to empower link workers so that they are efficient in their role.

We welcome the commitment to increasing link worker capacity. 5 link worker per primary care network is a good start. However, capacity will need to be increased, especially with the various link worker access points including self-referrals. A robust and effective voluntary and community sector infrastructure is also required to enable efficient delivery in order for link worker to hold a minimum case load of 200-250 per year’. Primary care networks ought to be supported to increase link worker capacity based on their local population need and as required; some may require more than 5 link workers to manage 200-250 case load per year. The consequences of inaction regarding increasing link worker capacity would include;

  • The link worker’s job becoming unattractive due to the unmanageable workload and burnout. Some link workers are already suffering burnout. Look after us to look after you.

“I am actually managing caseloads and not just signposting, it can be overwhelming”

  • Lack of patient confidence and poor patient outcomes. Patients resulting to the default; accessing clinical support for non-clinical need due to link worker waiting list. Some areas operate a link worker waitlist.

“I have asked the GP to stop referring patients until I have managed to finish supporting those that have been referred, we need more link workers”

  • Poor patient experience arising from link worker not empowered to have time to listen and to support the person. Here is what a link worker said is important

“the most important thing that I can do is to listen to someone – if I don’t listen there is no point in my link worker role”

Overall, universal personalised care is a welcomed aspiration. It is important that organisations understand how complex and crucial the link worker role is. And therefore, fully commit to supporting link workers so they can be effective in their role. Our link worker success conference coincides with Link worker day on 8th July.

For further comments and questions, please email info@connectlink.org

5 tips to developing a community centred social prescribing service

Social prescribing is about adopting a community development approach:

• Seeing the community as part of the solution and not the problem.
• Power shifting to the community to do something for itself.
• Engaging with the community in order to empower them.
• Citizen power rather than tokenistic or consultative engagement.

Arnstein, Ladder of Citizen Participation (1969).

5 tips to developing a community centred social prescribing service

• Identify the problem you are going to use social prescribing to solve
• Find out the real influencers in the community. This could be individually who do not usually get involved
• Go out to the community to earn some credibility and build trust
• Co-produce solutions with the community
• Empower the community to deliver the solutions

Save the date: 8th July 2019 is a day to celebrate social prescribing link workers nationally.

Are you a social prescribing link worker or a social prescribing organisation? Join the only professional membership network of link workers and their employers to realise your FULL potential.

Questions, enquiries and comments are welcome, please email info@connectlink.org

National Association of Link Workers responds to NHS Long Term Plan

We welcome the commitment to link workers in the NHS Long Term Plan ‘over 1,000 trained social prescribing link workers will be in place by the end of 2020/21 rising further by 2023/24’; especially as 8 July 2019 is link worker day, a day to celebrate and showcase the link worker profession to coincide with our flagship annual link worker success conference.

Key requirements for setting link workers training and link workers up for success.

1) The role of a link worker needs to be correctly understood by all.

2) To be successful in social prescribing link working, a link worker needs to have what we call the ‘link worker effect’:

–          Right personality

–          Right skills

–          Right knowledge

–          Right practice

Our code of practice for link workers will be launched at our conference on 8th July 2019.

3) Training should NOT be a ‘tick box’ exercise and should be linked to a career progression path. The training should help link workers carry out their role effectively. Link workers should NOT be under-trained in the core competencies that directly relates to their day to day role.

4) Link worker equity and fairness in pay should not be dependant on whether employed by a statutory or non statutory organisation; it should be based on the role responsibilities. Link workers are currently underpaid in relation to other similar roles; perhaps fuelled by a lack of understanding of the role complexities.

5) Employers need to enable positive link worker wellbeing, so link workers role model social prescribing and influence clients positively.

6) Manageable link worker workload. Over 1,000 is a good start but it is definitely not enough; waitlists are in operation in some schemes. Also, high staff turnover due to link worker burn out is becoming an issue. There are great examples of how patient participation groups are supporting paid link workers in order to manage workload; the role of volunteers in social prescribing needs to be recognised and supported.

Questions, enquiries and comments are welcome, please email info@connectlink.org

Social Prescribing link worker: 5 ways to boost client attendance

If you’re working in the field of Social Prescribing and seeing clients, you may have had days or even weeks where some or many people don’t show up. One piece of research has suggested that deprivation is the biggest driver of missed GP appointments (Lancet, Dec ’17) so it makes sense that Social Prescribing clients can sometimes be difficult to engage.

Here are 5 ideas that have helped me boost client attendance so that more people can benefit from our service

1) The telephone; it’s how you use it! It’s likely your first contact with the client will be on the phone. Here are some tips that have helped me to engage with my clients successfully. Getting hold of a client: Some people don’t answer unknown numbers, so you can text ahead to introduce yourself then call shortly after, or leave a voicemail or text asking them to get back to you (texting seems to trump voicemail nowadays!). OK, maybe this sounds too obvious, but it can be a tricky business! Ask: “Do you think a face to face appointment would be useful for you?” Ask this rather than going straight ahead and booking them in for an appointment they may not really be committed to attending. Telephone signposting: If your client’s needs are clear then simply assist them over the phone with the information they need to save time for both of you. Telephone appointments: These are great if your client has certain barriers (see point 2). Timing is everything: Use the information you have about the client to judge when might be the best time to first call. Maybe they are busy because of school runs or work or they are retired or unemployed. For me, overall I find more people answer late morning!

2) Discuss your client’s barriers. Our clients can feel that lots of things are holding them back, which is partly why they are seeking support (or the GP has recommended it). These barriers may stop them at the first hurdle from even attending a social prescribing appointment. Try to find a time, place and type of appointment that best suits your client (as far as you have the resources). Are they a morning person? They can have the 9am slot! Are they afraid of busy waiting rooms? Find out the least busy time for the practice (if practice based). Do they have a school run to do? Do they work 9–5pm or nights? Are they afraid of leaving the house? Do they have a bus to catch which is better at a certain time of day? Does that cost them money? Are they a carer? All of these factors might mean that someone misses an appointment or disengages completely, so be frank and try to get a sense of these within your first appointment with your client

3) Text an appointment reminder the day before. Sounds simple and many of you probably already do this, because often people forget or haven’t written down their appointments, but I’ve found that wording the message to promote accountability can actually make a difference! For example, I used to write something like ‘Hi ……just a quick reminder of your appointment tomorrow at 2pm at …..Surgery, Best wishes, Will’ and now I write ‘Hi….appointment confirmed for tomorrow at 2pm at ….Surgery. See you tomorrow. Will’. Perhaps the first one is too casual but since using the second one, fewer clients have texted me back to say ‘Sorry I can’t make it’ and more have attended, I think because it sounds more formal. So if you’re getting lots of no shows, try playing with your wording!

4) Sense your client’s commitment. After the first appointment, I always try to ask the client two questions. “Was that helpful today?” and “Would it be useful for you to have another appointment?” Of course, I also say what I think might be useful for them but it’s a joint decision. If you sense the client is being polite or hesitant and just re-booking because they think they should, then try to be open and say that it really is only if they think it would help them. After the first appointment they may still not be quite ready to get support or set goals, or it may not be for them.

5) Book short and long slots. I used to book 45 minute slots for all of my clients, but then if one doesn’t arrive that’s a lot of time wasted. Now I book 20 minute slots and 45 minute slots. The shorter slots work well for follow ups and more regular clients and the longer ones for new clients. I also ask the client which length of appointment they would prefer. This means I can book more clients in per day and if any don’t show up then it’s not as much of a problem.

Of course, managing our client case-loads is a bit of an art and it depends on the types of clients you’d like to engage. Here in Bristol, we are working in the areas of deprivation as part of a citywide Public Health backed project. I hope that in sharing my experiences you’ve picked up something useful and would love to hear your thoughts, ideas and best practice

Will Ship

Social Prescribing Link Worker Southmead Development Trust

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Social prescribing coming of age conference: 2 key issues that emerged

We were delighted to exhibit at the King’s Fund social prescribing conference on 6th November 2018.

It was a colourful event indeed and it was fantastic seeing familiar and new faces. Over 100 people caught our link worker effect and signed up for further conversation at our stand 🙂 We are very grateful for the lovely feedback from visitors to our stand. Here is a taster

‘it was a great event and I very much enjoyed visiting the Connect Link stand’

‘what a great enthusiastic & fun team, really enjoyed talking to your staff’

The secretary of state for health and social care, Matt Hancock also caught the link worker effect when he met with our CEO. Great support for link workers! In his keynote speech, he reiterated his commitment to social prescribing and that he was open to ideas with proven evidence and wasn’t wielded to a model. You can read his full speech.

2 key issues that emerged

2 key issues that emerged from the over 100 conversations we had with visitors to our stand:

1) Lack of a repository of all social prescribing schemes: visitors were asking for information regarding existing social prescribing schemes in their area. Social prescribing coming of age should mean improved coordination and dissemination of information. There now needs to be a collation of existing social prescribing schemes for easy public access.

2) Lack of social prescribing link worker role clarity

Firstly, it is important to clarify that we are referring to a non-clinical social prescribing link worker. It is worth noting that our members involved in social prescribing schemes are non-clinical and we are very clear about their role. Again, this highlights a lack of a coordinated dissemination of information.

The awaited NHS England social prescribing guide should help provide role clarity. Here is an excerpt.

Additionally, our ‘code of practice for link workers’ which will be launched at our ‘link worker success conference 2019′ will provide detailed role clarity. You may wish to sign up to our membership for further information

Next steps
Get in touch with us info@connectlink.org, if you have questions or for either of the following:

• Want to discuss membership?
• Want to support our link worker success conference 2019?
• Do you have an idea you would like to discuss with us?
• Do you have a project in the pipeline and would like to work with us?
• Would you like to get involved with our work?
• Do you want to be listed in our social prescribing marketplace?
• Want to discuss bespoke training?
• Do you want to discuss embedding social prescribing?

National Association of Link Workers response to the government’s loneliness strategy

We welcome the publication of the loneliness strategy and the prime minister’s unwavering support for social prescribing; ‘GPs in England will be able to refer patients experiencing loneliness to community activities and voluntary services by 2023’. We know only 20% of our health is accountable to healthcare and social prescribing is the appropriate resource for the 80% that are largely non-medical.

 

Non-clinical link workers are hugely crucial to the success of social prescribing. Clients/patients often see them as role models, therefore it is important that they are adequately supported and do not feel professionally isolated themselves .

The key to successful social prescribing is link worker:

  • – empowerment
  • – development
  • – support

 

 

7 actions that needs to be taken:

  1. Recognise that there are non-clinical and clinical link workers and therefore provide role clarity and guidance
  2. Provide a cross cutting national standardised curriculum for non-clinical link worker education/training
  3. Provide career progression routes for non-clinical link workers
  4. Decent pay for non-clinical link workers, up to a minimum of NHS band 5
  5. Recognise the role of volunteers and patient participation groups in social prescribing and therefore provide support and guidance
  6. Support link workers to role model social prescribing
  7. Provide an upto date national open access directory of services, community activities and community groups

 

Get intouch with us to chat about collaborating on these 7 areas or to learn more info@connectlink.org

Why the volunteer social prescribing workforce matters and should be supported: view from a volunteer link worker

How it started:
Our Social Prescribing and Wellbeing Project was set up at the GP surgery as a pilot project, about 18months ago, in response to an identified need. This need came about because a relatively new service, at the time, provided by a Community Navigator was becoming inundated and overloaded with requests from GPs across the city to signpost patients, who presented with non-medical issues, to services for support with a range of social or emotional (i.e. non-medical) needs.
The presentation to the Patient Participation Group (PPG) resulted in an interested group of volunteers being trained by the local CVS/Community Navigator team and then some of those volunteers taking the project forward with the surgery’s support.

Our impact:
• As volunteer link workers, we support the (18000 +patients) surgery by spending more time with patients who have non-medical issues but don’t know where else to go. Patients appreciate the time we give them
• For complex cases we can escalate to the Community Navigator
Support we received
• We received initial training which focused more on active listening and protective behaviours a couple of us spent time at the local CAB.
• The surgery is very appreciative of what we are trying to do and we have a proactive GP and Practice Manager who are keen that we should succeed.
• We have been invited to surgery meetings to give feedback and they would like us to have our photos on the board alongside other staff members to show the patients who we are.

How we work:
• Clinics are held on 2 half days per week so that a consulting room is always available
• We have devised a closed group scheduling system on Yammer
• We have produced a small referral pad which each of the GPs, Nurses and Receptionists can use to give to a patient to take to reception to book an appointment. This also acts as a reminder to the GPs of the service available by the volunteers.
• By developing strong links with the surgery, we have a secure email account that allows us to share referral forms back to the surgery to update patients records
• We have refined our IT trails so that we have as much face to face time with the patient as possible
• We are proactive in gathering leaflets, learning on the hoof, drawing on our backgrounds and general knowledge.

The issues have been:
Recruiting and keeping volunteers
• Finding a system for scheduling the rota
• Designing a system/paper & electronic trail that works for all parties
• Having a manageable IT system for recording actions and follow ups
• Having a dedicated space within the surgery to see patients
• Getting sufficient referrals from the GPs
• Lack of funding
Training for volunteers/ new recruits
• Knowing what 3rd party services are currently available
• Getting volunteers’ faces known around the surgery

Written by our member Angela Bettridge (volunteer link worker) The Maltings Surgery, St Albans in Hertfordshire.

Join us if you are interested in ending link worker professional isolation and would like a single point of access for empowering and supporting the social prescribing workforce inorder to help increase positive wellbeing outcomes for themselves, individuals and communities.

Why social prescribing is global

Some background information as to why social prescribing is global.

The United Nations (UN) 17 Sustainable Development Goals (SDG) was adopted in September 2015 by the Heads of State and Government and High Representatives, meeting at the United Nations Headquarters in New York.

The 17 Sustainable Development Goals, target by 2030

Goal 1. End poverty in all its forms everywhere
Goal 2. End hunger achieve food security and improved nutrition and promote sustainable agriculture
Goal 3. Ensure healthy lives and promote well-being for all at all ages
Goal 4. Ensure inclusive and equitable quality education and promote lifelong learning opportunities for all
Goal 5. Achieve gender equality and empower all women and girls
Goal 6. Ensure availability and sustainable management of water and sanitation for all
Goal 7. Ensure access to affordable, reliable, sustainable and modern energy for all
Goal 8. Promote sustained, inclusive and sustainable economic growth, full and productive employment and decent work for all
Goal 9. Build resilient infrastructure, promote inclusive and sustainable industrialization and foster innovation
Goal 10. Reduce inequality within and among countries
Goal 11. Make cities and human settlements inclusive, safe, resilient and sustainable
Goal 12. Ensure sustainable consumption and production patterns
Goal 13. Take urgent action to combat climate change and its impacts*
Goal 14. Conserve and sustainably use the oceans, seas and marine resources for sustainable development
Goal 15. Protect, restore and promote sustainable use of terrestrial ecosystems, sustainably manage forests, combat desertification, and halt and reverse land degradation and halt biodiversity loss
Goal 16. Promote peaceful and inclusive societies for sustainable development, provide access to justice for all and build effective, accountable and inclusive institutions at all levels
Goal 17. Strengthen the means of implementation and revitalize the global partnership for sustainable development

World social prescribing

As a result, organisations and governments globally are increasingly putting the SDGs at the heart of their impact framework and approaches.

Social prescribing impacts upon all 17 goals . As such, governments and organisations that are not yet aware of the benefits of social prescribing should be made aware and be supported to include social prescribing as part of their SDG implementation strategy. What are your thoughts?

If YOU are an individual or organisation who is interested or involved in social prescribing and would like to improve positive wellbeing outcomes JOIN US

We welcome local, national and international collaboration. Get intouch admin@connectlink.org