Now that the PCN DES is underway, this article looks at how you can ensure that your practice is making the most of your network's social prescribing link worker(s)
Social prescribers should receive accredited training to be able to carry out their role. There is training available on the e-learning for health portal which you can access here.
It would also be worth talking to your local training hub about other local training and development that may be available.
Different PCNs will be at different stages with regards to the development of the social prescriber role, if in the early stages consider reaching out to the local authority, local voluntary service organisations as well as your PCN clinical director to understand how to access a directory of services for your area as this will be key to the role' success.
Social prescribers should also be aware of your lone worker policy and sensible precautions must be taken if they visit people in their own homes. They should also be trained to recognise and seek appropriate help for those who are at risk of self-harm.
Social prescribers need regular access to clinical supervision to support them in their role. They will often see people in crisis and vulnerable situations. To be effective, social prescribers will need to be able to discuss the issues people present with, including domestic violence, sexual abuse, family dynamics, self-harm and suicidal thoughts, in a safe supervision space.
Social prescribers need dedicated time to offload and to have clear safeguarding procedures to help them deal with situations appropriately.
The NHS Futures collaboration platform has lots of useful resources. Membership is open to social prescribers, PCNs and colleagues involved in social prescribing. To join email firstname.lastname@example.org
Tasks for your social prescribing link worker
Once you have a social prescriber in post, the following are some areas you could look at asking your social prescriber to focus on:
Compiling an easily accessible directory of services
This is key to the social prescriber role, so if your practice or social prescriber doesn’t have access to a directory of service it is worth compiling one. The CCG, local authority, voluntary sector and other practices in your network are good avenues to start to identify the services available, referral criteria and list of charges if applicable.
This needs to be a live working document that the social prescriber keeps updated and also updates the primary care team on useful avenues for referral and support for patients
During COVID, the social prescriber could be in charge of contacting patients on the shielding list to check in and see how they are doing and link them with NHS volunteers or other local voluntary services as needed.
Similarly the social prescriber could be tasked with regularly checking in with COVID-positive patients. This should be done as part of a protocol and after training so that the social prescriber has a script and an understanding of the signs to look out. This will ensure that patients with mild symptoms are followed up and any that are of concern are referred to a clinician for further management.
Reducing health inequalities
The pandemic has highlighted the increasing gulf in health inequalities. It can be extremely difficult for primary care to tackle this as health inequalities encompass health, housing, social care education and a range of other factors.
One key place to start is to look at ethnicity recording and how this could be improved as this may not have been collected consistently. Your social prescriber could also look at local demographic data to identify the areas of deprivation in your practice and to run a search on patients who live in these wards, review their notes and contact patients as needed.. NHS England has useful information about this here.
Depending on what services are available locally some areas of focus could be:
Support for early years
Support for education and training, particularly if there are schemes available to help those on long term unemployment back into the workplace
Screening and vaccination uptake – particularly if correlated with areas of deprivation
Tuberculosis – identifying patients who are at risk and referring them for blood tests
This is a key area that your social prescriber can help with. The directory of services should identify local resources such as exercise referral programmes and cookery classes that can help patients become more physically active and eat a healthier diet.
Many of these may have changed how they operate during covid but there many online resources and apps that patients could be signposted to. Maintaining an obesity register is part of QOF, these patients could be contacted to ask them if they would like some help and support to lose weight.
It is good practice to have a carers register and to periodically check this list to ensure it is up to date. The social prescriber can link carers with respite services and social services for a needs assessment
Since the start of the pandemic the use of remote IT tools has increased dramatically, however not everyone is equipped to use them. Social prescribers could be the first point of contact for any patients struggling to access the practice online and help patients to register for online access and to understand how to use digital tools to access the practice.
This can really help reception as technical issues can often take a while to fix particularly and this allows patients some dedicated time to get to grips with the tools that could potentially help them to manage their health better
Mental health and loneliness
Everyone’s mental health has been affected by covid and lockdown. Social prescribers can provide a regular check in for those with mental health needs or who are lonely to be more connected and also to access online resources and other voluntary organisations that can provide befriending support.
- Fionnuala O'Donnell is a practice manager in west London and a CCG board member
- NHS England social prescribing summary guide
- NHS England information on social prescribing link workers
- NHS England social prescribing link workers welcome pack
- Patient information leaflet explaining what social prescribing is
- An information leaflet on self isolating for patients during the pandemic produced by Sale Primary Care Network's social prescribing link workers
- A GP's perspective on the value of social prescribing
- King's Fund explanation of social prescribing