Working closely with the voluntary sector

An Islington GP and the clinical lead for primary care and care closer to home in North Central London STP examines the benefits of integrating care:

In general practice, we’re seeing more and more people come through the system with complex needs caused by the wider determinants of health.

Things such as unemployment, financial difficulties or poor housing conditions. These can represent up to 70% of a patient’s issues and all of which, as a GP, I find it difficult to give support.

However, there is a solution: the voluntary, community and social enterprise sector (VCSE) are well placed to support people with these challenges, and I’m fortunate to work in Islington where we have a really strong and vibrant VCSE sector.

I find that when I refer people into that sector, they really flourish and can have a more proactive role in their own care. This means that I am freed up to focus on a patient’s medical issues; and patients see me less, which helps me to ensure I’m providing care to people who really need it.

This is why, as the clinical lead for primary care, I have been working with the VCSE sector and the five boroughs of North Central London for the past two years. We secured funding to actively bring together a wide variety of people – from the health sector, local authorities, public health and VCSE organisations – to run a series of workshops that helped us connect with communities and co-produce an action plan to help people address their wider health and wellbeing needs.

There were two key outputs:

  • A local VCSE organisation did some work to understand how we could support the people who link patients into the VCSE sector to have good conversations. They developed some effective outputs which will be used to create an education and training package.
  • To continue building and developing opportunities across North Central London, we set up a social prescribing and self-management support advisory group with representation from CCGs, public health, VCSE leads and clinicians from the five boroughs.

The advisory group has been meeting for about nine months, and we’re beginning to see a step change. We share good practice, filter information coming down at a regional and national level, and it’s helped to raise awareness of how we can work with the VCSE sector to offer their services to our local residents.

Our learning from working together at a North Central London level is also feeding into local areas. We are reducing duplication, coordinating services more effectively, and hopefully preventing people from falling through the cracks that emerge in the system when people work in silos.

In the new GP contract, there is a strong emphasis on the implementation of primary care networks. This is something that we’ve already been working on, so we have the building blocks in place. Commissioning of social prescribing link workers is in each of our CCGs commissioning intentions, and has been recognised as something that each of the boroughs need to prioritise over the next year – an aspiration that is strengthened by the NHS Long Term Plan.

We don’t yet have full coverage of one link worker per primary care network, but because of our existing advisory group we have resources we can share locally so areas are not starting from scratch and can move quickly.

Local Authority colleagues have also agreed to support our plans to deliver social prescribing link workers – so it’s a collaboration not just in health but across local authority too, and we were able to do that because we’ve had this work running for the past couple of years.

The key areas our advisory group is now focusing on include:

  • Developing the principles to support a social prescribing link worker service
  • Looking at how we can evaluate that service
  • Considering the digital resources required to support this approach
  • Considering the workforce and educational opportunities that will make this approach sustainable.

By working closely with the voluntary sector we can be absolutely sure we are addressing the needs of our local residents and that we are not asking VCSE organisations to do things they aren’t able to do.

Working together means we can be realistic about what’s achievable and it also helps us to recognise the importance of continuing to effectively fund the VCSE sector so they can rise to the challenges that come their way as a result through this work.

If you are looking to build networks from scratch, there are some key factors that need to be in place:

  • Good conversations
  • Building relationships
  • Ensuring equity of provision
  • Having some strong clinical champions

You can access support to start, continue or improve collaboration between health, care and VCSE sector leaders on the Institute for Voluntary Action Research (IVAR) website.

Dr Katie Coleman

Dr Katie Coleman is a GP partner at The City Road Medical Centre. The practice was established in 1999 in collaboration with Dr Josephine Sauvage, Chair of Islington CCG and together they developed the organisation into a thriving inner-city training practice.

She is the Islington CCG Governing board GP lead for Patient and Public Participation and the Chief Clinical Information Officer, leading on the development of integrated care records for Islington residents in collaboration with other CCGs across North London Partners in health and social care.

She is the North London Partners clinical lead in Primary care and Care Closer to Home, providing strategic direction on the development of Care Closer to Home Integration networks and Quality improvement support teams (QISTs), Access to GP services and social prescribing.

Katie has recently taken up a GP Director role for the Islington GP federation.

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  1. Belinda Johnston says:

    We’ve been thinking outside of the box in Suffolk as I run a ‘One Welfare’ charity called Our Special Friends (OSF) which is about the importance of animal companions for our health and wellbeing. We provide human-animal support services FOC through a local network of volunteers and by linking to already existing community resources. We fill a gap between the clinical worlds, accessing invisible vulnerability and hidden disability. Cases are referred to OSF by professionals and public. We create a sensitive local network of multidisciplinary support and care planning to enable independent living with enhanced quality of life. Companion animals save the NHS £2.45 billion a year in reduced GP visits. We need to harness the power of these meaningful relationships but our innovative initiative, like all the voluntary sector, needs sustainable funding.

  2. Ric Allhusen says:

    Hi Dr Coleman, here in Yeovil we are already working with outside agencies, through the ‘One ‘Teams, and have been for three years. We have seen some really good results which have made a difference to the hospital and ED in particular. To have the third sector involvement along with housing providers, CAB, drug and alcohol services, police, mental health, schools etc, we can make a real difference and transform people’s lives outside of the acute environment. The key has been to have persons who can think outside the box!!

    • Katie Coleman says:

      Couldn’t agree more, the success of this is definitely about thinking out of the box, being willing to try a new approach in combination with the more traditional approaches to health and care.

  3. Sirinda Bhandal says:

    Hi Katie, I wonder if we could have a chat? Its Sirinda from Simply Connect, we are supporting a number of social prescribing projects across London working with our local voluntary sector partners. We also have good coverage in Islington, would love to chat about how we can support your primary care network to access a whole population, cross borough social prescribing in Islington.

    • katie Coleman says:

      Hi Sirinda, really happy to chat. We are working really closely with Islington LA to develop our locality offer, so the time is right. Feel free to drop me an email and we can link up.