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How a social prescribing pilot in North Staffordshire is transforming GP services

Dr Ruth Chambers, OBE, highlights how a pilot scheme is helping patients with social, emotional and practical needs across North Staffordshire…

The Voluntary and Community Sector (VCS) Hub social prescribing project was launched as a six-month pilot in February 2015 as a ‘means of enabling primary care services to refer patients with social, emotional or practical needs to a range of local, non-clinical services, often provided by the voluntary and community sector.’

Due to its success the programme has been extended to March 2018 – to support capacity challenged local health and social care services. The VCS Hub is registered onto the national Social Prescribing Network.

Total referrals received into the service are now more than 900. The VCS Hub is receiving increasing numbers of self-referrals from individuals who have been signposted from Health  and Social Care services and is getting increasing numbers of referrals from GP practices.

Dr Ruth Chambers

The initial evaluation conducted indicated a clear need for this single referral point service with 65 per cent of health and social care professionals reporting limited knowledge of the voluntary sector and what it can offer patients. Over 75 per cent of respondents were unsure what support could be offered by the voluntary sector.

A physical presence is maintained at locations across the local health economy to build confidence and understanding of the voluntary sector and this has worked well and with the high numbers of staff turnover and team changes this remains a constant need.

More recent developments

There remains work to be done to ensure that all health and social care professionals conduct more holistic needs assessments which include VCS provision as part of the options that are available to offer their patients working towards true integration.

Recent developments have helped the VCS Hub to make progress with this. Over half of GP surgeries in North Staffordshire/Stoke are taking part in care navigation training and implementation – which has been rolled out from September 2017.

The aim is for front-line practice staff to work towards providing options to patients who ring for a GP appointment. They will be trained to ask questions and depending on response offer alternative options, where appropriate. The VCS Hub is one of these options and referrals can be made directly to the service.

Within social care, the VCS Hub has been given access to the Social Care ‘Care First’ database to ensure that all information that is needed to facilitate the referral can be gained.

This is on a read-only basis, and has proved very valuable. The project has been widely promoted to all social care teams throughout Stoke-on-Trent and North Staffordshire and frontline ‘First Contact’ staff are aware that there is an option to refer to the VCS Hub should it be appropriate on first contact with a client.

Future developments

Further work and resources are required to track individual progress in more depth, to demonstrate health & social care outcomes for individuals supported by the project. Increased ability to track patient outcomes will fully demonstrate the value and impact of the VCSE and the outcomes that can be delivered.

The service is working hard to integrate into the developing multi-specialist community providers in the area.

Inclusion within the care navigation scheme should help with this as practices form their locality hubs and put this process in place. We are recording the referrals and gaps and issues identified and reporting these to the CCGs hoping that further commissioning can enable bottlenecks to be removed or support services helped to expand their delivery.

Read more on social prescribing in Staffordshire:

Enhanced Social Prescribing for Primary and Community Care in Southern Staffordshire


Dr Ruth Chambers

Ruth Chambers OBE is Clinical Telehealth Lead at NHS Stoke-on-Trent Clinical Commissioning Group