Social Prescribing

Social prescribing and workforce development

The Improving Me Partnership developed and launched a Social Prescribing Concordat for Creative Health as part of dedicated NHS70 celebrations in July 2018. This celebratory programme included a Women's and Children's Symposium featuring contributions from academics and practitioners on perinatal mental health, language and literacy development as well as featuring case studies and best practice. A number of resources were produced and shared.

The concordat outlined the role and contribution of social prescribing in reducing health inequalities and underlined an ambition to capitalise on innovations afforded from better cross sector collaboration and partnership. The concordat was adopted by the Cheshire and Merseyside Health and Care Partnership, the Institute for Health Visitors and the Innovation Agency (AHSN) and new signatories have followed.

In October 2018 the Improving Me Partnership set up a national cross sector Women's Roundtable for women thought leaders committed to making a difference for all women and children through collaborative action and innovation. The roundtable ambition was to ensure: access to safe, high quality and equitable services to support informed choice and deliver care closer to home, with wellbeing as a driver. This roundtable led to a number of agreed actions one of which was to develop a pilot activity across the North of England to explore the impact of a social prescribing principles in a maternity context, specifically in terms of workforce development. A successful bid was submitted to HEE in January 2018. Pilot activity is now underway with a focus on Maternity Support Workers.

A number of challenges were identified through the symposium and the round table event for the delivery of safe, effective and personalised care for women and children and a programme of activity was initiated to address these through a creative health agenda, particularly in relation to vulnerable women where language barriers reduced the capacity for self- care and active engagement with NHS services.

A cross sector partnership was brokered and developed on behalf of Liverpool Women's Hospital midwifery team and health visitors to address a number of challenges simultaneously. These included the establishment of a community hub at Toxteth library for women where a lack of English is a barrier to accessing services, the development of an accessible community Baby Box distribution point; a dedicated learning programme called Stepping Stones for women and babies with English language needs, which includes a focus on self-care and health management; wrap around community led social prescribing provision which addresses perinatal mental health and attachment and bonding needs through a regular rhyme time and social gathering opportunity; strong links to Maternity Voices development; and additional free family learning opportunity to address wider family needs. This model is being emulated in St Helens and linked to an established language and literacy programme(BLUSH) for older siblings with a view to breaking the cycle of low educational opportunity feeding health inequality.

System blockages due to the limited availability of community interpreters are also being addressed through these initiatives. The development of volunteers for the programme is a high priority with an emphasis in supporting women with lived experience to engage with both Maternity Voices and the Stepping Stones activity to support women's personal development and promote community integration. It is anticipated this work will contribute to growing a future NHS workforce with a ready supply of aspirants with the right skills and values.

Nurse training and development activity

A national special interest group (SIG) for social prescribing and nursing was convened in January 2018. A steering group was then set up in the February. This steering group includes strong representation from the Improving Me Partnership and there is a clear focus on the implications of adopting a personalised care agenda for women's and children's services. The SIG steering group is also linked to the national Women's Roundtable. The SIG chair, Dr Michelle Howarth and the Improving Me representative, Jo Ward have been tasked in making representations to key professional nursing groupings at a leadership level to build a commitment to transforming the workforce. The SIG has now also taken forward a commitment to explore how to promote personalised care through the adoption of social prescribing principles and practice, unique placements and curriculum design.

The SIG will deliver a national conference at the end of 2019 with inputs from NHSE and HEE. The new NMC Standards for Pre-registration Nurse education provides an opportunity for HEIs to redress balance between medical and person centred models and promote a salutogenic philosophy to enable students to explore meaning of person and patient centred care. Explicating the personalised agenda within the curriculum will also help students to explore and describe theories of health and wellbeing related to personalised care and how these influence shared decision making to self-manage based on what matters to the individuals. This work in turn provides a platform to shape nursing CPD and inform the development of a focus on Maternity Support Workers across the North of England. This work sits alongside and will support a successful bid In January 2019 to HEE pilot to develop a new style curriculum for Maternity Support Workers in the North of England, aligned with social prescribing principles and practice and designed to support progression into healthcare professions, reflecting a Talent for Care agenda.

Through direct engagement with a national Medical Education SIG and a subsequent focus on the role of a creative health agenda in a secondary care context the Improving Me Partnership have submitted a proposal to the Innovation Agency for a symposium to bring Yale based academics to Liverpool to highlight how a creative health agenda can help support clinicians undertaking a reflective approach to self-evaluation of their clinical learning, as well as responses to feedback from clinical placements, patients and formal assessments. This symposium will also showcase innovations in the treatment and care of children where there is clear evidence of the value of a ‘more than medicine agenda' in both treatment and recovery in order to inspire further innovation.