On NHS Change Day, March 11, Luton Borough Council and Luton Clinical Commissioning Group, along with partners organisations, launched Luton Social Prescription, to promote health and wellbeing in Luton. Social Prescribing is about linking people up to activities in the community that they might benefit from, and connecting people to non-medical sources of support.
Here Marek Lubelski, Neighborhood Governance Manager at Luton Borough Council, shares how they have set up this project, what they have learnt so far and why they are holding their launch event on NHS Change Day. We wanted to create a model for social prescription in Luton by building on a real partnership across health, social care and the community sector that focusses on promoting health and wellbeing, not just managing sickness. Key to this is a step change in harnessing our local communities’ contribution as a resource to assist with reducing health inequalities, by helping people and community based organisations to become more connected, socially engaged and empowered to make healthier lifestyle choices.
Senior officers, clinicians and politicians at the highest level from across Luton Borough Council and Luton Clinical Commissioning Group were very keen on the idea of developing social prescription in the borough as part of our integration agenda. As a consequence we began to explore how we could make it happen locally using a community development approach.
I took on responsibility for developing the ideas, and set about researching good practice nationally, talking with a range of partners to develop interest. We set up a steering group with all our partners and, with the assistance of key experts with experience from other localities, began to develop detailed plans for how we thought Luton Social Prescription could work and how we could make things happen based on local needs and conditions.
The greatest barrier has been persuading people to invest in the social prescription model. Everyone understands that social prescription can help with preventing people becoming ill. It also helps many people with long-term conditions manage their health more effectively, as well as building stronger and more empowered communities. Unfortunately, with current resource constraints and demand already putting real pressure on front-line services, it is a challenge to find the necessary money to invest in the future. With so many partners involved, it was also necessary to work out who should fund the different elements of the investment, because whilst savings across the health economy are expected, how each partner will benefit will differ and be unpredictable to some degree.
Working together
Securing the investment was achieved by all partners working closely to develop a robust business case that focused on delivering benefits to patients rather than organisations. We were also able to demonstrate the risks of not investing and the potential long-term damage to the health economy and some of our most vulnerable communities. By everyone contributing their expertise, we were able to build a strong case for change that everyone was able to support because they all want what’s best for Luton.
We were fortunate that we already had some strong partnership networks in Luton. The CCG and LBC work closely together through the Better Care Fund integration programme. A new ‘wellness’ service has been commissioned by Public Health. The ‘Your Say Your Way’ community involvement programme also meant we had an established and practical partnership framework for engaging local communities and the third sector at a neighbourhood level for shaping and underpinning our work. We also engaged with key user groups and third sector organisations across the borough, and received significant support from HealthWatch. Everyone we spoke with saw the potential of social prescription and wanted to help
All the partners are currently considering how they can commit resources for the next three years, so we can fully develop the social prescription model and roll it out across the whole borough. Right from the outset, we are linking this work very closely with improvements in joint commissioning, so that the intelligence we gain from what is needed and working for patients and communities clearly shapes and focuses the way we use available resources. We are confident that social prescription will show clear benefits for clinicians and moreover will be valued by communities. Ultimately, sustainability will be determined by patient choice
People have started to think differently about what we mean when we say ‘NHS’. A recognition is building that the NHS is not just hospitals, doctors and nurses, it’s all of us in the community working together to improve our health and health services. Clinicians need individuals to help them help us. And all patients, carers, families and communities have to support our NHS to help us get well, stay well and be healthy.
What we have learnt so far
Since beginning work on the Luton social prescription model, I have been inspired by just how much creativity, energy and commitment to improving healthcare in the borough is being channelled from people, communities and professionals from all backgrounds. Everyone cares passionately about the NHS and the real health and wellbeing challenges faced by many people living in Luton, and they are brimming with ideas about how to make things better, and to make those changes happen. Social prescription has the potential to transform how we think about health and wellbeing and health and care services in a very practical way, and to put patients and communities at the heart of this change. By having conversations with people who have dedicated themselves to improving lives for people in Luton, I am increasingly understanding how essential it is that their views and experiences shape the future model of health and social care services.
It is too early yet to quantify the benefits to patients, but the approach to partnership working has already begun to lead real change in ways of working across organisations. Enabling wider recognition of the role of grassroots, community-based organisations in improving the health and social care system is confirmation that the direction of travel is positive and will lead to further benefits for patients and communities.
People can learn from our experience that there is real enthusiasm for the NHS and a great desire to help nurture it as an institution. There are also resources and expertise out there in the community that we can draw on to help us improve the way we do things.
All of us are trying to make urgent, practical changes that can deliver improved outcomes to residents, and to involve local communities directly in this journey.
We wanted to get involved in NHS Change Day as we want to share our vision and to be part of the day, so we can get feedback and ideas from others. Our Change Day event was to launch the Luton social prescription programme. For us it marks the beginning of the transition from having a shared vision to delivering real change and new services to the people of Luton.