Social prescribing is a big part of the loneliness strategy in England as well as the NHS Long Term Plan. On May 15th we held our latest Research and Policy Hub meeting, looking at how social prescribing might be able to tackle loneliness across the UK.
Social prescribing on the front line
We think there is real potential for social prescribing to help combat loneliness. We see it is a way to engage with the loneliest people in the community, develop a tailored response and connect them with the kinds of services and support they think would help them.
The Research and Policy Hub had a rich mix of people who had organically developed services as well as academic researchers who are bringing their rigour to understanding what works.
The story of social prescribing begins with the experience of front-line GPs, social workers and others. Tim Anfilogoff described just this organic process when he was developing services in Hertfordshire at the beginning of this decade. They could see the challenges their patients or clients faced and wanted to creatively respond with solutions that may be more social than medical. He is now working for NHS England as a facilitator to help local areas successfully deliver the NHS England social prescribing model.
“Because you’ve got to die of something”
Janette Powell of Reconnections Worcestershire, now taken on by Independent Age, showed how services need imagination and energy to connect to people’s interests. There may be a model of social prescribing but hearing her talk about how they organised for a group of bikers to take older people to an event on the back of their motorbikes “because you’ve got to die of something” shows this is about more than following a bureaucratic model. Simon Tucker of Independent Age showed how effective the service is – people have a measurable reduction in loneliness. And the improvement in people’s wellbeing is so great that people even use health services less.
Sometimes people just need a nudge
Jenny Hartnoll of Health Connections Mendip explained how their service started with “one GP who wanted people to be able to access support in one place. So we created a website to tell as many people as possible about the services available in their community, and we’ve already had over 70,000 hits in the last year”. And it’s about a lot more than a website; their service is a comprehensive approach involving the whole community. As well as connecting people to services, they are responsive to the gaps and help people to set up new groups of activities and interests. They have introduced badges for people to wear in the town centre saying they are happy to chat.
Jenny said that sometimes people just need a bit of a nudge – but others need intensive support for a long time. The results make a powerful case for more areas taking this approach: 81% of people they support had an improvement in their wellbeing. 93% said they knew more about the available support in their community. Better connections mean there have been big falls in the numbers of unplanned admissions to hospital.
Prof Sonia Johnson, Clinical Professor of Social and Community Psychiatry, UCL presented the findings from a NIHR School for Social Care Research study of a co-produced intervention for one group who really need intensive support: people with severe anxiety and depression. They are helping people understand their networks, work out their goals and then practically help them reach their goals. It’s still early days but they found improvements in loneliness, using the de Jong-Gierveld loneliness scale, as well as mental health.
Dr Suzanne Moffatt, Reader in Social Gerontology at Newcastle University is conducting an NIHR School for Public Health Research study on the impact of a community based social prescribing intervention with a particular focus on health in the west of Newcastle an area of high deprivation. She found people whose lives had been greatly improved. One woman told her team: “My health has changed a lot … it’s made me feel a lot more confident that there’s somebody there.” Another man with COPD said the service “restarted me again … they’ve been really, really good … they’ve stuck with me.”
How can we measure our success?
Despite these stories, capturing these kinds of improvements is not easy. Social prescribing is a complex intervention that can never be captured by a single measure and so we need to be sophisticated in how we evaluate it. We need a breadth of measures including ethnography as much as health service utilisation data.
The challenges of how to focus social prescribing to the needs of those experiencing loneliness were at the centre of the presentation by Kate Jopling, a strategy and policy consultant who has worked with the Campaign to End Loneliness since it was founded. Her key challenge is that social prescribing won’t tackle loneliness by accident. It may do other good things but unless we measure it, train practitioners to recognise and respond to it and provide acceptable support and services it will not work for loneliness in the way we hope.
The Research and Policy Hub was a powerful demonstration of how connecting people working in services, academia and policy can create a deeper understanding of an issue than looking at an issue through one lens. We will work so that these insights can help maximise the opportunity of social prescribing so that fewer people will be lonely in the future.