Interest in social prescribing – where patients are referred to local, non-clinical community services such as walking clubs or self-help groups – is on the increase across England. There is also growing recognition of its potential to help meet the ambitions of the Five Year Forward View and of sustainability and transformation partnerships (STPs) to support people in managing their own care.
Social prescribing is a common feature of many local STPs, welcome recognition of the benefits it can bring for patients. These include better quality of life, improved mental and emotional wellbeing, and lower levels of depression and anxiety. It also has the potential to reduce patients’ reliance on NHS services, easing pressure on accident and emergency wards and hard-pressed GPs. But perhaps social prescribing can be not only an element to deliver STPs, but also an inspiration for the development of those plans.
I previously worked on two projects in Bristol: Healthwatch Bristol and the social prescribing service Ways to Wellbeing. In my role with Ways to Wellbeing, I often met people whose days and weeks were filled with appointments with their GP, at hospitals or with mental health specialists. The people I worked with were used to focusing on what they could not do. They went to medical professionals with the expectation that the professional knows best and that their service would ‘fix’ them. In this medical model of treatment, the patient has the problem, the service has the solution.
Social prescribing, and Ways to Wellbeing, take a different approach: looking instead at what the person is doing, could do or would like to do. Most importantly, the Ways to Wellbeing staff know very well that they do not have a readymade solution. They provide ideas and create a safe space for people to consider their options; but ultimately it is the person who knows themselves best, and therefore an idea they generate for themselves is far more likely to be successful than an idea a staff member imposes on them – however well intentioned.
So how does this relate to STPs?
STPs are being led, primarily, by people with a background in delivering health and social care services. They have spent years doing their upmost to treat and cure patients. Their hospitals, community services and GP Practices are the places we go to for help when we most need it. They fix us. They provide us and the people we love with solutions – and we expect it from them.
STPs, however, require something different. STPs need innovation, not just pre-determined, tried and tested methods of working. STP leads do not and cannot be expected to have all the answers and, importantly, neither would we (the public) want them to because, just as the Ways to Wellbeing clients know themselves better than the service’s social prescribing facilitators ever will and have so many assets within themselves on which they can draw, it is within the public that the future of STPs lies.
A social prescriber does not prescribe the solution, but provides the environment in which the person can consider their options and help form their own plan of action. Similarly, STPs are a great opportunity to provide space for people to engage in conversations about how they view and use the services around them, and how they can envision using those services differently in the future. This is about creating solutions with communities, not trying to answer every question on day one.
As a social prescribing facilitator, I experienced the discomfort of feeling that I could not solve everything for a person who came to me for help. I understand why STPs wanted to develop plans to a certain level before talking to the public about the detail. But I have witnessed the power that giving a person a voice and the time to be creative with their future can have. I urge those developing STPs to put the public at the heart of their conversations. This would give us the best chance to shape the future of our services – our ‘solutions’ may just surprise you.
All views expressed in this article are the personal views of the author and not those of organisations mentioned.