Support for Commissioners

Recent research by National Voices clearly highlights that social prescribing is most successful when there is a strong relationship between the health care system and the voluntary community and social enterprise (VCSE) sector.

It’s critical you establish and develop a strong and equal partnership with your local VCSE sector from the start.

Recommendations:

1. Speak with your local VCSE infrastructure organisation – Councils for Voluntary Services (CVS) and Volunteer Centres – who are experts in your local community. They have extensive knowledge of your local VCSE sector, and will know what services are already running and the local priorities and needs. They will know the best ways to involve the VCSE sector in your plans and should be a key partner for you to achieve your social prescribing objectives.
2. Speak with existing Link Workers and any other wellbeing projects running in your local area. It’s important to build on existing services, projects and relationships within your community, and involve them in your plans.
3. Identify a ‘lead’ for your VCSE partnership to ensure you have a clear communication channel with the sector. This may be via a key organisation i.e. infrastructure or key anchor organisation, or it could be via a particular VCSE Steering Group or Network.
4. Embed your Link Worker team within a VCSE partner organisation who can ‘host’ the staff. This ensures that social prescribing is truly embedded within the local community.

Useful Resources

• Next Steps for Social Prescribing in London
• National Voices – Rolling out Social Prescribing
• Bringing people together: how community action can tackle loneliness and social isolation
• Connecting communities and healthcare: Making social prescribing work for everyone
• Community partnership – prevention in practice
• VCSE Sector Engagement and Social Prescribing
• Redbridge Social Prescribing – Case Study

The design and delivery of social prescribing services will differ slightly from borough to borough. That’s because they’re designed around local health needs and priorities – some may focus on a specific client group or health condition, while others may deliver the service differently to be able to reach marginalised people.

To create a service that will really make a difference to local people, make sure you co-design it with a range of partners across different sectors of your community.

Recommendations:

1. Speak to a range of people and organisations to find out what the health and wellbeing priorities are for your local community. This should include primary care, emergency services, and social care teams, as well as the VCSE sector, community health services, schools and local residents.
2. Speak to your local VCSE infrastructure organisation who will be able to link you with existing community networks. Also, speak to your local Healthwatch who will be able to introduce you to patient representatives and groups.
3. Keep your different stakeholders involved throughout the life of the service – not just at the initial design stage. By keeping this communication your service will be able to improve and evolve over time to best meet local needs.

Useful Resources

• The Asset Based Health Inquiry – How best to develop Social Prescribing?
• Social Prescribing: Incorporating London’s major housing associations into the GLA’s Social Prescribing Vision
• Enabling the potential of social prescribing
• An exploration of co-commissioning approaches to social prescribing services
• Resources for Children & Young People’s Social Prescribing

Before you start, consider how to ensure your service is fully funded.

You will need to consider:

1. Using a full cost recovery model – make sure you build into your budget all staff costs, recruitment, training and development, IT equipment, office space, and management charges.
2. Could you build in additional funding to your budget to cover the delivery costs of the activities you’re referring your clients into, or to set-up new services where they don’t already exist?
3. Have you included costs for new digital systems to help you manage your social prescribing project, considering any GDPR consultancy and training you might need.

Useful Resources:

• Social Prescription Plus – Case Study
• The Asset Based Health Inquiry – How best to develop Social Prescribing?

Social Prescribing is recognised by NHS England as having the potential to hugely improve health. It’s part of their Long Term Plan, and funding has been pledged for Link Worker roles until 2023/24.

However social prescribing is reliant upon a strong, active and vibrant VCSE sector. There is no funding pledged to the VCSE sector to specifically support social prescribing. Some VCSE services are commissioned or funded through dedicated funding, however many are delivered without any long-term or secure investment.

Careful consideration is needed when designing social prescribing to ensure it’s delivered in a sustainable way that enables VCSE services to continue delivering their services to benefit local residents. 

Recommendations:

1. Allocate a proportion of the service budget to cover the cost of VCSE services, if required. There are some services that adopt a ‘payment by referral’ method, with funding following the client to pay for the community services they access.
2. Allocate additional funding to develop new support services or activities by communities to meet local needs, where provision may not exist or meet demand. Again, the VCSE sector are experts in developing new services and building community networks, so are best placed to support and manage this work.
3. Try to understand the full cost of community services that you refer clients into. Some activities or groups may be ‘free’ to attend, but everything has some sort of related cost – whether it’s staff time, venue hire, refreshment costs or administration time. It’s important to consider this to aim for a truly sustainable service for the future.

Useful Resources

• Social Prescription Plus – Case Study
• Connecting communities and healthcare: Making social prescribing work for everyone

As with any service, it’s important you’re able to clearly monitor and evaluate the outcomes of social prescribing – for the health and wellbeing of the person accessing the service, but also on your local health and care system, and local communities.

A clear and robust evaluation allows you to clearly evidence the impact of your social prescribing service.

Recommendations:

1. Firstly, consider what you want to be able to demonstrate from your service – where do you want to measure differences, and what do you want to be able to evidence?
2. Work with data specialists to develop a framework that maps out the data you will need to collect, how this will be consistently captured and stored across the service, and what processes you need for reporting and analysing data.
3. Consider which existing evaluation tools are most suitable for your service to capture wellbeing measures from your service users;
   Patient Activation Measures (PAMs)
   Recommended by NHS England (however feedback from Link Workers is that it’s too clinical for social prescribing services)
   Office for National Statistics (ONS) Personal Wellbeing 4
   A brief but widely used questionnaire – seen as a more appropriate and useful measure for social prescribing services
   Short Warwick-Edinburgh Mental Wellbeing Scale (SWEMWBS)
   Originally developed to use with children and young people, this easily accessible resource for individuals looking for information on how to measure children and young people’s mental health and wellbeing.

Useful Resources

• Measure your Wellbeing Impact
• NHS England Social Prescribing Summary Guide
• Redbridge Social Prescribing – Case Study