Wales Roundtable: Social prescribing approaches to reducing inequalities in Wales and promoting the role of link workers in Wales

Wales Roundtable: Social prescribing approaches to reducing inequalities in Wales and promoting the role of link workers in Wales

The National Association of Link Workers held a virtual roundtable for Wales Link Workers and key stakeholders on the 9th of June 2021. This virtual event was one of 12 annual UK social prescribing link worker roadshows held virtually by the National Association of Link Workers in May and June of 2021.

This roundtable focused on two sessions: a bottom-up discussion to highlight how social prescribing approaches have helped to reduce inequalities in Wales; and a second session focusing on how social prescribing can be better supported in Wales.

A broad range of link workers and stakeholders were in attendance, leading to a rich and vibrant discussion. Participants included:

  • Sarah Brown – local community coordinator, Llynfi Valley
  • Sally Rees – National Third Sector Health and Social Care Co-ordinator, Social Prescribing Manager, Wales Council for Voluntary Action
  • Dr. Ceri George – Senior Project Officer, Social Prescribing, Mind Cymru
    Mike Howell – Social Prescribing Link Worker, Cwm Taf Morgannwg Mind
  • Gail Devine – Community Navigator, Bridgend Association of Voluntary Organisations
  • Helen Howson –  Director, Bevan Commission
    Mair Hopkin – Joint Chair, RCGP Wales
  • Christiana Melam -CEO, NALW

Social Prescribing Link Workers in Wales serve a valuable role in their communities. Opportunities to bring together link workers, managers and other stakeholders across Wales provided a valuable opportunity to share approaches, as well as discuss the key issues impacting link workers and enablers.

Key Points

  • Health inequalities have been put into the spotlight due to Covid, which presents an opportunity to address key factors.
  • Greater research and policy changes are needed to reduce the drivers of health inequalities and require a greater understanding of inequalities through the health legislative agenda (Healthier Wales and the Transformation Programme; and Social Services and Wellbeing and Wellbeing of Future Generation Acts).
  • Issues related to lack of access to transport as well as limited access to digital resources are key factors that increase inequalities.
  • Social Prescribing provides an opportunity to focus on the individual and how they deal with issues and plays a role in tackling the impact of poverty.
  • It is important for issues related to poverty to be addressed head-on: debt, housing insecurity, lack of employment opportunities, poor transport can increase feelings of isolation. These complex issues are hard to unravel, but social prescribing puts the person at the centre, providing a valuable role in helping an individual tackle key issues impacting their wellbeing.
  • There is also a need to keep people connected with each other and fill the gap between the different generations, as this is an area of widening inequality and access. By accepting and addressing the key challenges individuals face, social prescribers can help them address issues one by one and help them develop solutions to move forward. By connecting the solutions to a time scale, it can provide a framework that helps the individual achieve their goals, without feeling overwhelmed and gives them a plan to work with.
  • It will take a lot of time for people to get back to their lives before COVID, with many in need struggling to get access to healthcare but still requiring care and support.
  • Covid has limited open access to GPs-there are numbers of people disadvantaged by surgeries limited in being able to answer phones, make appointments, or relying heavily on digital appointments that could limit access to elderly patients. Social prescribers can help provide feedback around access issues back to GPs.
  • Who is looking after the holistic needs of a patient? There is more that can be done to help ensure better care and efficiency in care with an MDT workforce in primary care that includes social prescribing link workers.

Referral rates increased during the pandemic when self-referrals for social prescribing were possible. This allowed people to access non clinical mental health support to avoid going to their GPs, as well as taking pressure off of GPs. This direct referral route has proved to work well, especially in areas where GPs have used it.

Recommendations

  • Challenging and promoting a model for health that is not solely predicated on a medical model for health, but rather balances medical and social, dictating when GP intervention is needed, and when other courses of action are better to meet an individual’s needs.
  • Making sure your work is filling the needed gaps, rather than replicating existing activities helps maximise impact for the community.
  • It is important to develop pathways based on clinical and non-clinical pathways that are driven by the needs of a person.
  • Additional research is needed on social prescribing work to underpin the development and promotion of a national offer in Wales, as well as support the valuable research already undertaken.
  • Social prescribing is an active form of service instead of a passive one. Communities should play a more substantial role in both promoting social prescribing, but also creating linkages for support.
  • Greater funding is needed to support social prescribing and prevent short-term approaches that provide stop-gap measures. Commitments to continued support are needed to ensure staff retention and institutional knowledge are safeguarded.
  • There is a need for a national model of delivery so that people get the required services that they need.
  • Civil society and academics must play a more prominent role in national efforts to promote social prescribing.
  • Proper strategies should be made to develop a national offer that can better promote and raise awareness around social prescribing and the existing services that are being offered to enable greater uptake.
  • Greater collaboration amongst the different organizations working to reduce health inequalities, engaged in social prescribing, and support communities. These organisations should combine their knowledge and learning to advocate for better facilities and funding.

Challenging and promoting a model for health that is not solely predicated on a medical model for health, but rather balances medical and social, dictating when GP intervention is needed, and when other courses of action are better to meet an individual’s needs.

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Not only will they be able to champion social causes, but they will be able to channel their energy and talent into achieving better health outcomes for others.

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