Initial insights from the Institute for Social Prescribing during COVID-19

The South West Academic Health Science Network (SW AHSN) launched its Institute for Social Prescribing in late 2019 to support innovative practice in social prescribing across South West England and beyond. Social prescribing is an approach whereby healthcare professionals introduce people to a range of non-medical support in communities to boost their health and wellbeing.

The emergence of COVID-19 meant original plans for the Institute had to be adapted. Like many projects on the ground in the South West at this time, the Institute’s test beds – local social prescribing teams who are contributing focused learning and insight through the Institute – reconfigured their provision to respond to local needs. Some of the work originally planned with the Institute unsurprisingly slowed down. At the same time, the speed and depth of learning accelerated in other areas.

As part of a six-month insight gathering project, the SW AHSN is working to capture and share how social prescribing teams under the Institute for Social Prescribing were responding in the early days of the COVID-19 crisis, and to consider the important role of social prescribing to local communities, particularly in areas where health inequalities already exist.

We’re now mid-way through, and have taken the opportunity to pause and reflect on the insights we’ve gathered to date. What we are observing is the ability of social prescribing teams to rapidly adapt and respond in a complex and rapidly changing local situation.

What have we learnt about how we can help social prescribing to innovate and spread?

Looking across the responses to COVID-19 we notice there is no single approach or model that the social prescribing teams followed. Instead, each team responded in different ways according to their local circumstances, their history and starting point, where they are in the journey, and the systems in which they operate.

This isn’t a surprise – some test beds have been offering social prescribing for over five years, for others it is a more recent part of their practice. There is hidden deprivation in a number of the test bed areas, and younger populations in others. Some operate in well-developed local systems, while in others the relationships across statutory services and other organisations within the community are developing.

Yet alongside these differences, we also see commonalities. Inspiring and enthusiastic individuals are involved in all teams and test beds. During COVID-19 and at other times, social prescribers:

• Identify and work with people locally that may have few other places to turn
• Build relationships and partnerships with other local services
• Proactively support wider community capacity building, enabling the development of support services to link people into
• Help bring about changes to how teams within general practice work.

What has become apparent during the first few months of the insights project is the benefit of understanding the combination of differences and commonalities to spread practice. Doing so can help others in the region (and further afield) to take learning from sites in the South West and apply what is relevant and useful in building and developing social prescribing in their own context.

The way the Institute operates is key. As well as working with its test beds, the Institute works with researchers, policy makers and other practitioners in the region that are committed to spreading social prescribing as efficiently and as effectively as possible. By building on structures and systems of the South West Academic Health Science Network, the Institute remains dynamic and agile, able to react and change focus as the situation on the ground changes.

As a team we’ve seen how a regional footprint is helpful to spreading innovation. ‘The South West’ is an appropriate size to enable the spread of good practice at scale, whilst also being identifiable to its residents. This can help to avoid the ‘that won’t work here’ argument against learning from others. We’ve observed how the Institute can play a role in bringing about change more widely by acting as a bridge between local and national partners, with practitioners and academics.

The Institute places the test beds, its local social prescribing sites, firmly in the driving seat. It is empowering them to lead change, creating a safe space to test ideas and open up debates, as well as highlighting the multiple routes to success and providing a platform to share this learning. It’s working with people that have benefitted from social prescribing as well as academics, to bring together evidence with personal and practitioner perspectives.

For the responses we’ve observed we believe the approach of the Institute is something that practitioners and policy makers alike should watch – and not just for those interested in social prescribing. We’re looking forward to uncovering more learning over the coming months, about the specifics of social prescribing but also about how the Institute as a model of learning progresses.

From what we’ve seen, the approach could apply to many areas in health and care. What is particularly interesting is the way it could enable people with experience on the ground, whether users or practitioners, to feed these experiences up the chain to inform national policymakers through regional infrastructure.

You can read more about the test beds and insights I’ve mentioned here in our interim report (pictured right), including a summary of what we’ve learnt so far and where we plan to focus next.

We are continuing to work with our colleagues in the five test beds, and across other parts of the South West Academic Health Science Network and Institute for Social Prescribing, to uncover and share learning from the COVID-19 pandemic. This is happening between teams to enable what works to scale and develop as rapidly as possible in the South West and beyond. Together we are exploring the ongoing impact of COVID-19 on sustainability and funding, tackling health inequalities and primary care and general practice. If you’re involved in social prescribing or working to spread change in health and care we’d be interested to hear from you. Do get in touch!

We’re publishing case studies on the response of a number of local test beds within the Institute for Social Prescribing. You can read our case studies on the responses of test beds in Ilfracombe and St Austell. More coming soon.