We spoke to more than 300 charity colleagues over the six months of this project in order to understand how the roll-out of social prescribing through NHS England, primary care networks and CCGs has been for them.
We started this work before we knew that COVID-19 would hit us all, and hit England so much harder than many other places. But we are confident that the learning we have generated stands, and is now maybe more relevant than ever.
The aftermath of the initial pandemic spike has left many care pathways disrupted, has led to long waits, and means many people can’t or won’t access the care they need. Both A&E and primary care are reporting a surge in pent-up or new demand – things are tight in the service, and will remain so.
The community and charity sector too faced huge increases in demand – people have more urgent needs, they need bespoke advice and information, and existing service models had to be adapted. And all these needs have to be met against the backdrop of community fundraising falling off a cliff – a particular problem for patient charities, who tend not to be able to rely on grant and statutory funding.
One thing that can happen when people feel the pressure is that they pull back from shared initiatives, from innovation and risk-taking – they become more conservative, stick to old ways of working and give up on the possibility of a new culture. But none of us want this to happen in relation to social prescribing.
We found a huge appetite from the Voluntary, Community and Social Enterprise sector to engage with the health system constructively – to the benefit of people and communities whose needs aren’t easily compartmentalised into ‘medical’ and ‘non-medical’. Ours is a sector that rolls its sleeves up and makes things work – and that’s what we heard was happening, up and down the country, as organisations worked to make social prescribing a success.
So we are pleased to see that the NHS has committed to further recruitment of link workers, and has signalled its determination to continue the work to shift towards the personalised care that we know is what’s needed. Now is not the time to step away .
Of course, as we spoke to our colleagues working in communities, we heard about things we need to put right as we continue the roll-out of social prescribing: questions around measurement and reporting of data; questions around how to ensure link workers are well supported, and able to integrate into their wider local health systems; and questions around how we can get the relationships right at every level.
And of course we heard questions about funding for the community and charity sector, who cannot continue to meet growing demand without sustainable resourcing. This challenge precedes the arrival of social prescribing as a centrally mandated programme – and its resolution can no longer wait.
Getting ready for the winter and a possible second wave of infections, we cannot assume that the charity sector will be there to support communities in the way it stepped up first time round. Our sector has played an enormous role in protecting the NHS by supporting people in their communities. But in the next few months, charities are expected to shed 60,000 jobs. The sectors current activity levels cannot be taken for granted.
So, there is work to do, and it is work we must do. Because in these times of immense pressure, we need more than ever the kind of holistic, person-centred support that enables people to cope with waits, with service changes, and with the impacts COVID-19 has had on their lives and communities. If we get social prescribing right, we can deliver that.