Agenda item

The Committee received a presentation on social prescribing from Dr Katie Coleman, Clinical Lead of NCL Personalisation about Social Prescribing. In addition, the Chair of the Caledonian Park Friends Group shared her experience of being involved in a friends group and the health benefits arising from the use of open and green spaces. The Parks and Open Spaces Manager contributed to the item. The following points were made:

·         Members were reminded about the value of parks in terms of improving the health and wellbeing of its residents. In the challenging economic climate, it is important that the Service maximises and promotes the benefits of the parks for its residents. It is not a statutory service which would give it some protection from cuts.

·         Park Services bid for Heritage Lottery Fund (HLF) Accelerated project which aims to transform park services into a health and welfare service.

·         The HLF bid is a joint bid with Camden Council. A key part of the project would require working in conjunction with the health sector to establish core links and partnerships. If the bid was successful, l the service would have funding for the transformation.  If it was not, the transformation would be a slower process.

·         Dr Coleman informed the meeting that the NHS is promoting Social Prescribing (SP) which refers people with social, emotional or practical needs to activities or community groups.  There is a recognition by GPs that there is an increasing level of complex, long term ailments which requires a different approach.  Up to 70% of patient appointments are at least partly the result of socioeconomic issues and would be better treated with a non-medical intervention.

·         Social prescribing could be described as a ‘listening and connecting’ service where help is given to patients to build on their own personal strengths.   The link worker introduces them to their own local resources of which parks could be of one of the resources available.

·         Members were advised that although it is too early give a definitive analysis of the benefits, SP is gaining traction and is included in the NHS England Long Term Plan and Universal Personalised Care Model 2019 which stipulates that GP practices should come together as a network employing a social prescribing worker.

·         Dr Coleman advised that evidence indicates that SP results in improvements to both the emotional and physical wellbeing of residents.  The link worker could direct them to the appropriate service or support including for financial advice, education training, volunteering and physical activity. 

·         Following consultation with the patient, the link worker, trained with both the skills and knowledge, would be able to produce a personal health care plan that addresses long term needs such as facilitating a park run, referring them to knitting classes or signposting them to the appropriate benefit support.

·         In response to a question, Dr Coleman acknowledged that the link worker in his or her capacity will plug the gaps that presently exists in the current system through developing this person-centred care.  What SP aims to do is change the discussion from ‘what is the matter with you’ to ‘what matters to you’.

·         Anecdotal evidence shows that referrals to community services would result in reduced GP visits and emergency services appointments, which releases resources to support those in immediate medical need.

·         In Islington, ten health navigators work across eight GP networks and in multidisciplinary teams, communicating with people who have complex issues and referring them to the necessary support service. If necessary, the link worker would accompany patients to their first appointment especially where they lack confidence or are experiencing anxiety.

·         Members were advised that for SP to be effective, the infrastructure would need to be in place and staff trained.  Mapping out the opportunities available is a big task but vital for the system to work.  The use of parks and open spaces, and the opportunities they offer, is currently underdeveloped. 

·         With regard to accessing the SP link scheme, members were advised that referrals would be from clinicians, social care providers, VCSE organisations and self-referrals.

·         Although SP currently focusses on adult services, there is a recognition that children and young people experience mental illness, obesity and social isolation which cannot be ignored especially as no statutory services presently exist to support them.

·         Members heard evidence from the Chair of Caledonian Park Friends Group on how her life had been transformed following her decision to participate in park activities following an illness. She became involved in the Friends Group because she wanted to spend time in her local park.  Meeting other volunteers and being instrumental in getting things done restored her confidence. She indicated that since her involvement in the park she has been medication free, having not visited a GP for two years.

·         In response to a question, the Chair of the Caledonian Park agreed that referral of those suffering long term ailments such as obesity, loneliness and mental illness would be beneficial to their well-being.

·         In response to a question about residents being confused about what category their entry to Islington in Bloom would fall under, the meeting was advised that applicants could submit photographs to officers who would assist them.

·         With regards to the involvement of GPs in SP, members were informed that Islington currently has a number of navigators within the listening and connecting service which has resulted in an increase in the number of referrals. The primary purpose of health navigators is to actively engage with GP practices and promote what they can offer on a regular basis. Members were advised that Age UK has recently employed a person to actively promote the service.

• The Parks and Open Space Manager advised the meeting that, if awarded, the HLF funding would allow work to be done to identify what the service can offer and would ensure that a coherent offer is presented to the GPs. The project would build the links and infrastructure to support people who wish to participate and ensure that the staff and, where appropriate, community groups are skilled, trained and able to manage the vulnerable patients.
  
  
• In response to a question on the involvement of the transport department in the Parks for Health agenda, the meeting was advised that although not directly involved, other council departments such as planning, leisure, housing and highways are all involved in delivering health outcomes.  Islington is promoting cycling and walking. The Healthy Streets initiative was mentioned as was initiatives in other boroughs including Waltham Forest.
  
  
• With regard to the funding challenges experienced by volunteering groups, the meeting was informed that although resources are finite, local authorities support community groups for example by charging peppercorn rents for facilities such as community rooms, toilets and cafés. The Open and Spaces Manager advised that the Accelerator Fund project would consider ways of unlocking funds.  Parks services must be able to evidence the benefit of parks and open spaces and associated cost savings that will arise as a result of investment in health and wellbeing.
  
  
• In response to a question, the Chair of Caledonian Park Friends Group welcomed working with CCG and GPs and suggested that working with the Friends Forum would be beneficial.
  
  
• The Parks and Open Spaces Manager reiterated that although the Service is engaged in positive activities such as working with special needs schools and mental health charities and facilitating guided walks there is no structured programme. However, a successful bid would allow this work to be more formalised.
  
  
• Information sharing and communications, between Greenspace and groups and between groups, could be improved as could communication with the public about the opportunities available to them.  This would maximise the value of the work that already takes place in the parks and would help the over-stretched staff.
  
  
• In response to a question on the bid, the Open and Spaces Manager advised that it is looking promising.
  
  
• Members were informed that in an attempt to attract a new audience into parks, the Park Services will be trialling an interactive App in Caledonian Park which highlights the positives of the park..