Beginning the session, Jeremy Hughes from the National Academy for Social Prescribing said that it has been seen as the preserve of the NHS, putting linkworkers in GP practices. However people come into the system through a variety of routes, often after listening to trusted advisors. Cross-Government, there is an acknowledgement that we need to be working together.
Ingrid Abreu Scherer, Head of Accelerating Innovation at The National Academy for Social Prescribing, said that social prescribing is a way to connect people to practical support in their communities. How it works and who does it is something still to be decided, but at the heart of social prescribing is a conversation and a relationship. The two people having a conversation need to decide what matters to the person requiring care and support.
Social prescribing is good for everyone, but is particularly good for people with one or more long term health needs, those needing mental health support, and those who are lonely or isolated.
As much as 90% of health outcomes are not directly related to healthcare, she explained, and as many as one in five GP visits are not related to clinical needs. Investing in social determinants is the only way to achieve lasting change. A person-centred approach is needed, and everyone has a part to play.
People access support either independently, via community support (friends and neighbours), or through specialist support.
The National Academy for Social Prescribing is setting up a working group and has a workshop ‘Building social prescribing into your team’ next month.
Emma Tobin from Stonewater Housing Association then spoke. She explained that in 2021/22 they turned their attention to enabling communities. They wanted to change their relationship with customers by thinking about their wellbeing, personal assets, and strengths. They have worked alongside Community Catalysts to achieve this. They connected with staff and residents in three areas, listening to what was important to them, sharing positive practice and stories.
They asked the following questions:
· What matters to you about this local area?
· What are you good at?
· What are the strong parts of the local community?
· How could things be even better?
· How and where do they meet with people in the local area?
· What makes them feel valued, heard and included?
She gave the example of a Stonewater location which had a bus stop with no seating area. Stonewater owned the land behind, so are currently looking to create a seating area.
Janice Small, Neighbourhood Coach at Bromford then spoke. In 2016 they moved to a neighbourhood coaching approach, with smaller patches for the staff which enabled them to build relationships with the tenants, but it did not happen overnight.
Janice has built up connections with local organisations such as food banks and the police; she has also been able to understand what the tenants' aspirations were. The purpose at Bromford is to develop communities so that people can thrive, by understanding and coaching them.
Richard Harral, Founder of the charity ‘We Build the Future’ then spoke. He explained that the charity was set up to raise funds, improve support for people living with cancer (directly or indirectly), and to promote health and wellbeing which will reduce the incidence of cancer.
It is estimated that there are 150k people working in the construction and built environment industry affected by a cancer diagnosis. 44% of occupational skin cancer diagnoses are in the sector, and smoking amongst construction workers is twice the national average.
There are poorer health outcomes for people in the construction industry. Poor mental health is driven by long hours, lengthy commutes, pressure to complete jobs on time, and time spent away from family.
‘We Build the Future’ set up a pilot on a Kings Cross project, where they took health professionals on-site and conducted 16 clinics over 6 months. The majority of conditions they saw were chronic ones, and the feedback was that there was an enormous appetite to engage with it. Covid has changed how we access healthcare, through e-consultations.
Dr Sophie Yarker, Research Fellow at Manchester University Urban Ageing Research Group, concluded the afternoon with a discussion about creating spaces for an ageing society. Her presentation focused on the neighbourhood and social conditions needed to support social prescribing; and how an understanding of the role of social infrastructure can assist.
Physical spaces such as community centres, places for volunteering, and outside spaces are important to social prescribing work. They all form part of the social infrastructure which brings people together through a shared interest and purpose.
Social prescribing is the end point, which relies on formal/informal networks, which in turn relies on social capital.
When considering commercial venues such as coffee shops, research done in Honolulu looked at older people’s use of such a venue. It found that whilst the people didn't go together they were all there at the same time, and their social interactions were informal with no expectations of each other. This is known as 'Civil inattention'.
Banks and post offices are also important social spaces, even if the interactions are fleeting and sometimes non-verbal. 2017 research by the Citizens Advice Bureau found that 65% of people aged 65+ thought that these places were either important or very important. Yet in recent years many have been closed.
Hairdressers and barbers are a further social space. They are unassuming and are accessed regularly, with a trusting relationship built between barber and customer.
In conclusion Dr Yarker said that these examples are all mundane spaces, but are used by most people at some point. Social interactions occur there, and give the opportunity to develop ‘weak ties’.
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