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Mohan Sekeram, GP & Social prescriber preacher at Wide Way Medical

How to get buy-in for Social Prescribing

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Mohan Sekeram, GP & Social prescriber preacher at Wide Way Medical

  1. 1. SOCIAL PRESCRIBING Getting ‘buy in’ Dr. Mohan Sekeram, Clinical Lead Social prescribing Wandsworth and Merton
  2. 2. Overview • Why Social prescribing ? • Merton model • Model in Long term plan • Working for primary care networks – ‘Buy in from primary care, Council, VS.’ • Opportunities • Challenges
  3. 3. INTRODUCTION WHY ? TO SOCIAL PRESCRIBING - Links patients to ‘non- medical’, community based sources of support (20 %) - Housing, Debts/ benefits, social isolation , employment.. - Determinants of health - Provides GPs with ‘non- medical’ referral option - Medical mode Psychological – Social
  4. 4. • DEPRESSI ON OTHER CAUSES TO SYMPTOMS W • BEREAVEMENT • HEART PROBLEMS • FINANCIAL CONCERNS • RECURRE NT INFECTIO NS • HOUSING ISSUES
  5. 5. Social Prescribing Service Key Aim( How) To connect people with local activities and services across Merton which can make life more enjoyable and/or provide practical support Via Link worker/ social prescriber
  6. 6. Link worker at practice (embed into primary care) PROCESS ( how) 1. GP: - Completes referral form - Gives SP booklet to patient Link worker reviews patient and documents on Emis Completes wellbeing star Advises and signposts 2. 3. 4.
  7. 7. - Patient stories - Wellbeing Star (used at baseline and follow up) - 75 patients had completed two stars, with an average increase in overall wellbeing score of 0.7; Increase from 2.8 to 3.5. Statistically significant (t = 1.99; p = 0.00 ) EVALUATION (what) (QUALITATIVE) 1. Not thinking about it 2. Finding out 3. Making changes 4. Getting there 5. As good as it can be
  8. 8. - 138 visited the GP within 3 months of SP. - They took up 1,641 appointments before SP and 1,098 afterwards (reduction of 543). - The average number of appointments per patient reduced from 11.9 to 8. - T-test analysis shows that this is a highly significant reduction in the number of appointments (p value = 0.00). This box chart shows the number of GP appointments patients attended three before and after their first Social Prescribing appointment. GP APPOINTMENTS AT 3 MONTHS APPOINTMENTS 3 MONTHS BEFORE SPAPPOINTMENTS 3 MONTHS AFTER SP AVERAGE APPS: 12 AVERAGE APPS: 8
  9. 9. - 36 patients visited their GP within 6 months of SP. - They visited A&E 60 times before SP and 31 times afterwards (reduction of 29 visits). - The average number of appointments per patient reduced from 1.4 to 0.7. - T-test analysis shows that this is a significant reduction in the number of appointments (p value = 0.04). This box chart shows the number of A&E appointments patents attended six months before and after their first Social Prescribing appointment. A&E APPOINTMENTS AT 6 MONTHS A&E APPOINTMENTS 6 MONTHS BEFORE FIRST SP A&E APPOINTMENTS 6 MONTHS AFTER FIRST SP AVERAGE VISITS: 1.4 AVERAGE VISITS: 0.7
  10. 10. Reduction in GP appointments • Rotherham study – 28 % reduction in F2F • Hackney – reduced by 21 % ( 6/12 post) • Tower hamlets –reduced by 12.3 % ( 6/12 post) • Bexley – reduction in non- elective admissions of 60% ……
  11. 11. - Patient B seen before Christmas 2017 for Depression and medical certificates. Seen monthly for 4 months - Saw Ray- Identified he work as chef and other benefits. - Job at community center ( July 2017) - Bottom photo – November 2018 - Currently working and off medication and no more medical certificates. - Self esteem - Resilience - Supporting community - Reduced use primary care SOCIAL PRESCRIBING IN ACTION
  12. 12. Buy in from primary care • Showing quantitative data • Seeing qualitative date – can see patient types….. • Easy process to referral • Embed in primary care ( member of the team) • Feedback and outcome..
  13. 13. Personalised care • One of the 5 key priority areas in the LTP. • Patient choice and control • Takes whole system approach integrating services • 6 enablers
  14. 14. Primary care networks • DES provides workforce reimbursement to build expanded Primary care team • Year 1 ( per 30—50k population ) – 1 Clinical pharmacist (70/30 split) – 1 Social prescriber ( 100% funded) • Year 2 – PA, Paramedics, MSK.. (or second social prescriber) • Year 3 ( 3rd social prescriber ) ……….
  15. 15. Potential Support for Networks • Create Personalised care plans • Diabetic input- healthcoaching • Dementia awareness • Home visiting ? • Social determinants • Embed into MDT team
  16. 16. Buy in from Voluntary sector • Include in the journey • How will it impact them • Align services and not compete – Acknowledge what is existing • Funding for voluntary sector – Evaluate – Ccg, bids for charitable funds, social enterprise… etc (Mark swift – wellbeing ) • Volunteer staff
  17. 17. Rough runner Oct 2019( Team Merton)raised 3k
  18. 18. Buy in from Council • What is strategy – Focus on community, preventative • Build network connectors • Health & wellbeing board – Similar aims • BCF/Steering grp/Evaluation – Born June 2016 • Joined party August 2016
  19. 19. Factors to support scheme • Collaboration/ engagement with stakeholders – Public health, Voluntary sector, primary care.. • Identify needs in area , deprived vs affluent, young vs old, JSNA • Steering group meetings (composition ) • Evaluation • Support for voluntary sector and Social prescriber
  20. 20. MERTON PATIENT STORY
  21. 21. Challenges • Getting right model for your area.. • Not seeing full benefits.. ( uptake year 2) • Engagement of all voluntary sector (small) • Funding for voluntary sector ( demand) • *Support and supervision for Social prescribers • *Evaluation of impact on Voluntary sector (downstream)
  22. 22. Opportunities • NHSE pledge funding for 1000 link workers by end 2020/2021 • Integrate with community. • Promotes health and wellbeing and reduce health inequalities. • Reduce impact on primary and secondary care • Health and wellbeing of practioners.
  23. 23. THANK YOU. ANY QUESTIONS? www.dontmedicalise.com Instagram - Social_doc_prescriber Twitter - @SekeramMohan

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