The London Borough of Waltham Forest set up a social prescribing service five years ago. The team works with primary care in the NHS and community groups across the area to link people in with activities and support. Loneliness is one of the most common reasons for a referral. But thanks to the support being provided residents are being helped to learn new skills and take part in a variety of activities, reducing isolation in the process.
What was done?
Waltham Forest Council’s public health team set up a social prescribing service in 2016. It started off with one social prescriber before expanding to three. Funding was then obtained in 2018 to pay for three social prescribing posts in the voluntary sector, before another nine social prescribers were recruited in 2020 to work across the local primary care networks as part of NHS England’s national programme.
The service mainly works with more than a dozen different services, which run activities from creative writing and singing through to luncheon clubs and walking groups. Three quarters of referrals come from GPs in primary care with the rest from adult social care and mental health services. Loneliness is one of the most common reasons for a referral.
Waltham Forest senior social prescriber Sharon Hanooman said: “Ever since we set up the service we have been inundated with people needing help. Prior to COVID social isolation was the second most common reason for a referral. Debt and welfare advice tended to be the most common, although even with those you would find that social isolation was a big problem.
“Many of the referrals we get are where relationships have broken down or people have been left isolated after bereavement. But it is really surprising just how many people are isolated and don’t have strong social networks – I think there is perhaps a London factor in all this where there is not always the sense of community where everyone looks out for each other that you get in some places.
“The pandemic has just made that worse. People’s social networks were disrupted and they were left isolated and alone at home.”
Once a referral is received, the social prescriber has a guided telephone conversation with the resident and then helps them to access the support they need. The social prescriber will provide on-going support for up to three months, making follow-up calls to see how the resident is progressing.
Prior to COVID the service was supporting just under 1,000 people a year – half of whom had low mood and anxiety or felt socially isolated. Those figures have risen by a third during the pandemic.
An evaluation of the service by the University of East London prior to COVID found the programme was making a tangible difference to the lives of people it was helping. For every £1 invested, the return on investment was calculated at £1.92.
One of the people who has undoubtedly benefitted from the service is Lloyd Fenton. He was referred to the service after suffering a stroke and being diagnosed with epilepsy. He had had to give up work as a teacher and was feeling depressed and isolated after moving into shared accommodation.
As a result of the contact with the Social prescriber Lloyd started doing an arts class organised by the Waltham Forest Adult Learning service based at Walthamstow Wetlands centre, but since then he has gone from strength to strength by training to become one of the social prescribing buddies as well as getting a job as a support assistant at a local college. He said the service has had a major impact on his life, helping him meet new people and learn new skills. “I feel so positive.”
As the service has been rolled out, extra elements have been incorporated into it. Alongside the activities people can be referred to, the service can link people with befriending service to provide more intensive support. There is a service for the over 60s that is run by Age UK, Just Connect, and a new separate service commissioned by the council for the under 60s, jointly managed by Crest Waltham Forest and Waltham Forest Community Hub, which was recently launched this year.
Ms Hanooman said: “We have appointed two voluntary sector organisations to run the under 60s service. It is telephone-based as well as offering a face-to-face befriending service. We found we were seeing significant numbers of younger people being referred in because they are lonely and more parents with young children who have become isolated.
“Befriending is reserved for people who need that little bit extra support or who are not ready to get involved with the activities we can prescribe. Social prescribing is light touch, it is aimed at people who have low level problems with the idea of providing support before the problems become more serious.
“The community groups that run the activities were reporting that some of the people were requiring more help than they could really give. That is where the befrienders come in. The support is limited to six months with the aim to help residents to re-engage with local community activities.”
Another addition, launched at the end of 2019, is a buddying service to provide people with someone who will attend activities with them. Ms Hanooman said: “We found that people were not always going to the activities we had arranged for them. We would ask why and people would say they were not feeling well or something had cropped up, but when we dug a little bit deeper it became clear it was because they did not feel confident enough to go on their own. It was daunting.
“So working in partnership with a local voluntary organisation, Waltham Forest Community Hub, a team of volunteer buddies were recruited who can attend the first three sessions of a community activity with the resident. We are very careful to avoid the clients becoming dependent on the buddy. We don’t go to their homes, but instead meet them in a coffee shop or on the way to the activity. The social prescriber buddy is a catalyst to support the resident to get them through the door.”
Unsurprisingly, the pandemic has caused a major disruption to the support people have been able to be provided with. Ms Hanooman said: “We have always been a telephone service – the social prescribers do not meet people face-to-face so when the pandemic hit we were in a good position to keep that side of things running. But, of course, the activities that we refer people on to did stop or moved online.
“There were some virtual exercise classes and meet ups online. But that has not been possible with every activity. And another barrier is that the people we support do not always have access or able to use digital technologies.
“There has been very little we have been able to do for them and as a result we are seeing people being referred in with quite complex problems. It is not the caseload we would normally work with but we are monitoring it very closely. We have people who are really anxious about COVID and do not even want to leave their homes.”
She said there is also a challenge in getting some of the activities re-started.
It is a slow process. Staff are anxious. So we are launching what we are calling ‘wellbeing cafes’ once a week in three community venues.
“We are providing people with a chance to have a cup of tea or coffee and inviting community groups to run things like arts and crafts and cooking activities at the cafes. It will hopefully help get things restarted and help us meet the huge challenges we have.