Social prescribing – the power of time and connections

Case study summary

The NHS Long Term Plan commits to rolling out personalised care across the country. This includes widening the range of support available to people, including a commitment to over 1000 social prescribing link workers within primary care networks by April 2021.

Arabella’s life was turned around when her doctor referred her to a link worker. Alongside the GP’s medical care, the link worker gave Arabella the time and support necessary to make the connections that restored her wellbeing.

Arabella Tresilian is a management consultant. She had maintained a career and hectic schedule for years, balancing work and family by constant juggling. Alongside this, Arabella’s autism was a fact of life which sometimes made the challenges of this schedule harder to deal with.  But in 2015 things fell apart.  Her doctor recognised that her autism had combined with other events to cause post-traumatic stress disorder and chronic fatigue.  Juggling was no longer an option. Even everyday activities became overwhelming.

Recognising that Arabella needed more than just medication to help her get well again, her doctor referred her to a social prescribing link worker. The link worker spent time with Arabella to help identify the things that mattered to her, and to look at what options were out in the wider community. The options ranged from art classes to yoga, and included knitting, singing, walking, gardening, museums and reading groups. In Arabella’s case, it looked as though singing would be a good fit for her, and so she joined a choir. Three years on, she is still singing and has recovered her poise. Her confidence has returned and she is now helping other people cope when they have issues with their mental health. “I’m balancing my life, I work part-time, I’m involved in many activities and I feel good about the future,” she says. “Social prescribing made all the difference to me and now I’m able to give back to my community.”

Diane Girling was Arabella’s Link Worker. She works for a Bath-based charity, Developing Health and Independence which offers a social prescribing service called MyScript. Diane said, “Working with people like Arabella is a joy. It meant helping her unpick her complex and overwhelming situation. Together we were able to look systematically at the issues that were affecting her, including finances and employment amongst other things, and help her find something she could do for her wellbeing.”

As a social prescribing link worker Diane helps people to make a holistic assessment of their situation. This often means looking beyond the initial condition that has brought the individual to the point of seeking help. She encourages each person to think about how their wellbeing could be improved, starting from where they are and opening up options with them. This can include giving information about services and community groups that they may not have been aware of. Together they also look at what’s getting in the way of making the changes that the individual may want to make and discuss ways of moving forward.

Summing up her role, Diane says: “As a link worker, it is a privilege to give people time to be heard, space to consider positive changes in their lives and empowering them to move forward.”

Veronica Kuperman, who runs MyScript’s link worker service says; “Our aim is to encourage long-term behaviour change. We work with people who are often in crisis, anxious, stuck, ambivalent and fearful about accessing services and we help them to unpick the areas where they need some support. We take a motivational approach, helping to promote independence and resilience. The ‘social prescription’ is jointly created by the link worker and the individual. Most of the time giving somebody information about activities or courses is not enough. It’s about helping people to identify what’s important to them and to develop their knowledge, skills and confidence so that they are able to make changes that restore their wellbeing.”

Veronica’s view of social prescribing is confirmed by the comments of people who have been supported by a link worker:

One of the biggest things (about the service) was a sense of being heard. The ‘nuts and bolts’ part helped too, but feeling heard is more important, it is not sympathy but being heard and understood. The manner of the facilitator gave me a sense of hope; it was no fake cheerleading.

When life has fallen apart, to have someone ‘hold your hand’ back into ‘normality’, with compassion and encouragement, is so incredibly helpful.

In summary, Veronica says: “If social prescribing is going to make life better for people – whether that’s the people who need support or the people who work in busy health and care services –  it has to be more than just signposting. It has to be about promoting a holistic definition of health & wellbeing and finding different ways to achieve it by equipping individuals with resources, internal as well as external, to support long-term behaviour change and better self-care.”