Presentation from Brian Dickens and Les Persaud, from the Croydon Social Prescribing Community Engagement Team.
The Croydon Social Prescribing Community Engagement Team representatives introduced the item by explaining that the Croydon SocialP had been built on creating engagement opportunities, providing support with the aim of affecting long term behavioural change and developing local opportunities to assist in health self-management. The Panel heard that referrals to these programmes could come from General Practitioners (GPs) or self-referrals from organisations or individuals, with sustainability and community development at the heart of the programme.
The Croydon Social Prescribing Community Engagement Team representatives explained that patient lists for GP practices were increasing and becoming unmanageable, and that 20% of consultations that took place at GPs did not require clinical intervention. There were a minority of patients taking up a majority of time at these practices, and this combined with a shortage of GPs and reduced NHS budgets had created a strain on these services. The Social Prescribing model would seek to reduce this by moving to a model of health self-management and modifying patient and community behaviours.
The Panel were informed of some of the prominent local health issues for Croydon, with some of these being obesity, poverty and lack of exercise. Life expectancy in Croydon was 9.1 years lower for men and 7.7 years lower for women than the national average. There were also significant social issues including high unemployment, social isolation, diet, community cohesion and mental health (among others).
There were plans to build local providers and community hubs which could be referred to from GPs and eventually from patient self-referrals. The overall aim was to improve the patient experience while connecting and joining up services with a multi-agency approach, and to develop more holistic community interventions. The Croydon Social Prescribing Community Engagement Team representatives informed Members that over 60 partnerships had been developed, and these included the council, local councillors, MPs, corporations and others. The Croydon Social Prescribing Community Engagement Team representatives informed the Panel that one of the projects had been started with £1000 funding from a ward budget, and now had attendances of up to 100 people per week. It was stressed that no money had been taken from the corporations who the programme were in partnership with, but other forms of support had been provided in the form of equipment and marketing, etc.
The Croydon Social Prescribing Community Engagement Team representatives talked in more detail about some of these partnerships, including NHS England, who had been vital in providing access to a control group. Nuffield Health in Croydon had agreed to start a cinema club for isolated people, and were also providing swimming time to patients. Palace for Life were running seven local programmes, and the Parchmore Church had been running a Food Stop project which aimed to provide cheaper food for 200 families.
The Panel were informed that the programme had won the NHS Parliamentary Award for excellence in Primary Care, and had received national media coverage. There were 32 community hubs signed up to participate in the programme, and 42 GP practises; in addition to this there had been over 40,000 attendances in the 12 months leading up to the Panel.
Members learned that the programme would seek to develop additional partners whilst building on existing resources to help avoid duplications. Additional work would be done to identify local gaps in provision and develop interventions to these. The programme had been impactful but cost effective, with less than 20% of the budget having been spent over a 16 month period. The programme was compiling data and case studies to gauge how effective it had been, but at the time of the Panel there were around 2000 attendees per week and there had been a 19% reduction in avoidable visits to A&E.
The next steps for the programme were to assist in the Local Voluntary Partnership and to extend the programme into providers of secondary care as well as pharmacists, dentists and opticians. There were also plans to increase the GPs in the community programme and to develop greater youth engagement. Relationships with corporate partners would be cemented in addition to other vital relationships of the programme.
The Chair thanked the Croydon Social Prescribing Community Engagement Team representatives for their presentation, but raised concerns about some of the corporate partners with regard to whether they paid the living wage and had ethical investments, but expressed hope that the programme might influence them to do the right thing. With the large number of attendees to the programme and limited funding from the CCG, the Chair queried how partnered voluntary associations would be supported given that their funding had likely been tight and their workloads increased. The Croydon Social Prescribing Community Engagement Team representatives agreed that it was important to support these organisations and informed Members that members of these organisations were deliberately on boards the programme had set up so that this could be managed. Funding and supporting these organisations had been a focus of the programme to ensure local delivery. The Director of Alliance Programme agreed that there would likely be an increase in pressure on the voluntary sector, and that it would be a good idea for the council to look into this to see where it could pick up capacity or increase efficiency; it was stated that this could be achieved through joint commissioning with the CCG.
Members stated that they were glad that this programme was being delivered and seemed to be having an immediate impact. They were not aware of any voluntary organisations that had said they would not be able to deliver this because of funding, but that some were unable to find spaces to deliver services; this had been solved in part as many organisations (such as churches) were letting halls for reduced rates, or for free, to these organisations. Members were aware of some organisations with a social prescribing agenda built into them, who could be approached to fund projects.
Members enquired as to whether a lack of English speaking had exasperated any of the issues which the programme looked to address and were told this had potentially had an effect. The Croydon Social Prescribing Community Engagement Team representatives stressed that they wanted to look at ways to address this which were not overly prescriptive, and that they wanted to bring people together to develop solutions, instead of simply sending them to English lessons.