NHS England plans to meet this challenge through primary care implementing it’s strategy – Universal Personalised Care.
Central to the strategy are the groups of general practice established by NHS England – Primary Care Networks. These cover populations of 30 to 50 thousand and their role is set out in a new contract. NHSE is currently consulting on the specification for the contract.
Social Prescribing is:
- trying to break the barrier between clinician and community by providing a route for General Practice to connect people with other people and resources in their community.
- only going to be successful if GPs and their team change the way they work – to better understand how to build on personal strengths and what communities have or could have.
- in danger of putting more pressure on poorly funded community resources and the voluntary sector.
So, if we want social prescribing to be effective we need to create a local narrative that helps us to understand what is happening in a way that:
- helps General Practice change its culture
- motivates GPs, citizens and community organisations to engage with it
- brings what citizens can do for themselves or with others to the fore
- keeps funders local and national informed about the effect that social prescribing is having on community infrastructure
This is fundamentally a local issue.
What we need to do
We therefore need to create a sophisticated but straightforward mechanism to ensure that there is feedback coming back on the difference that social prescribing is making and how it can be improved.
The primary audience for this feedback must be:
- the GPs working in a particular network
- the people who have used social prescribing
- the community organisations who are working in that area
- other voluntary organisations
- Local Funders
What NHS England are proposing in the consultation
In the PCN Network contract specification NHS England are proposing that Primary Care Networks report on the number of people who have been ‘socially prescribed’ and that this minimum target should rise each year as follows:
20/21 – 4-8 social prescribing referrals per 1,000 weighted population
21/22 – 8-12 SPR/1,000 WP
22/23 – 12-16 SPR/1000 WP
23/24 – 16-22 SPR/1000 WP
This simple quantitative target is purely about activity it tells us nothing about where people went, what their needs were, what difference this “prescription” made to their lives and what costs the referral placed on others such as the community or the voluntary sector.
These metrics only feed Whitehall – they give an illusion of impact but only count activity.
Quantitative performance management like this is completely at odds with an initiative that aspires to change relationships and bring quality to life.
What we need
I suggest that Instead every primary care network is required to hold a yearly workshop with people who have received “social prescriptions” local community organisations and local voluntary sector. This meeting should discuss the difference that social prescribing made, the challenges that it faced and the actions that need to be taken to improve it.
The report from this meeting should go to the practices in the PCN, the CCG and to NHS England. The National Academy for Social Prescribing should be required to analyse these and produce recommendations back to DHSC and NHS England.
What do you think?
Acknowledgement – thanks to Charlotte Augst CE of National Voices for the ‘heads up’ and the inspiring conversation