Gill Bruce, Development Manager of Lorn & Oban Healthy Options Ltd, a Scottish social prescribing and self management project, has seen first-hand how social prescribing can benefit patients in rural communities. Healthy Options’ latest programme in their partnership with Access Elemental Social Prescribing, THRIVE, has been game changing by offering self-referrals and driving significant benefits to patients in the west of Scotland.
With patient wait times across the NHS at an all-time high, we need to ensure that everybody gets the care they deserve through the correct care pathway. Social prescribing bridges the gap between health and social care by enabling clinicians to refer patients to local, non-clinical services that would best support their specific need. Traditionally community nurses, GPs and mental health professionals connect patients to social prescribing link workers so that they are referred to the right community-based programme. This could include participating in group exercise, taking part in a new class, or joining a bereavement network. The goal of social prescribing is to empower patients to improve their health and wellbeing by developing new skills and connecting with their communities, whilst giving clinicians the ability to treat those who may need more urgent care.
Healthy Options partnered with Access Elemental Social Prescribing (previously known as Elemental), a digital social prescribing platform, in 2019 to help deliver and scale social prescribing in Lorn and Oban. Healthy Options uses Access Elemental’s platform to improve the organisation and efficiency of day-to-day tasks, as well as measure the effectiveness of the programme. Our partnership has been very successful as since the launch of THRIVE in February, we have seen 277 new referrals into the project, and since using Elemental in 2019, we have seen 1,220 referrals across both ADAPT and THRIVE. Awareness for social prescribing across the region has grown significantly and the benefits of it are being realised by both patients and healthcare professionals.
Social Prescribing in Scotland today
Scotland has been named as one of WHO’s pioneers for its global campaign of physical action, and social prescribing has played a key role. Though social prescribing is becoming more widespread across Scotland, I’ve witnessed first-hand its benefit in reducing health inequalities within rural communities where issues like alcoholism and drug-related hospital admissions can often be higher. With nearly a fifth of Scotland’s population living in rural areas, access to prescribing programmes is important. Healthy Options is one of the first initiatives catering specifically to rural areas such as Lorn and Oban.
We work with Access Elemental Social Prescribing to support the delivery of two programmes in Lorn and Oban – ADAPT and THRIVE. THRIVE was launched in February 2022 to empower people who require minimal support to improve their wellbeing by adopting healthier behaviours and routines. ADAPT is a 12-week specialist programme for people who need specialist support to learn and embed self-management strategies, or for those who require rehabilitation in relation to illness, injury or surgery. After completing the ADAPT programme, 67% of people choose to continue managing their health by joining THRIVE, where 20% of people come via self referrals, and the rest come from other 3rd sector organisations or health services. Currently, there are 66 clients in the ADAPT programme and 176 in THRIVE.
Self-referrals are transforming social prescribing across Lorn and Oban
Self referral to these types of initiatives is something that hasn’t been widely explored as patients generally require GPs to refer them to such programmes. In this aspect, THRIVE is a pioneer in social prescribing, enabling patients to take ownership of their health journeys and showcasing different avenues for improving health, apart from traditional clinician appointments. People who are referred into Healthy Option’s THRIVE come through Access Elemental’s platform where they are triaged to ensure THRIVE is the right service for them. Patient outcomes can be easily viewed and measured to monitor if additional support or advice is required from a GP or other health professional.
Although there are various routes through which patients can join the THRIVE programme, 20% of referrals into THRIVE come from patients themselves. We know GPs across the UK are facing severe backlogs and struggling to cope with long waiting times for their patients. Social prescribing offers them an avenue to ensure that patients needing non-urgent care are being supported, in return freeing up time and reducing the burden on clinicians. When there isn’t a digital route for referrals, like what is offered by Access Elemental Social prescribing, the process can be lengthy and burdensome. With the ability for patients to independently assess whether THRIVE can support them and self-refer, demand on clinician time can be reduced, helping free up their time for those who need their specialist skills.
Increasing efficiencies for clinicians
The various referral methods into THRIVE have been game changing for social prescribing in Scotland, particularly in rural regions where GP resource is scarcer. As a result of the Healthy Options programmes, which include but aren’t limited to social prescribing, GP attendance fell by 17% and unscheduled care attendance reduced by 26% in Lorn and Oban. As self-referrals into the programme increase and awareness for social prescribing grows further across the west of Scotland, GP attendance is expected to fall even further. There are also significant cost savings being recognised through the project. Our figures show that the estimated financial benefits for the Health and Social Care Partnership (HSCP) include a collective five-year cost avoidance of £439,699.
Supporting patients and giving them ownership of their care journeys
Since those applying for social prescribing programmes themselves want to see changes to their health, this can lead to far higher success rates and positive outcomes within the programme. Our recent survey showed that 78% of those who are part of the programme feel it does not need any improvements and enjoy the social prescribing scheme as it makes everyone feel welcome and allows individuals to find a community which they may have struggled to do in the past. Users of the service have also said since joining THRVE, they feel less inclined to visit their GP. Healthy Options is built on the foundation that cost should never be a barrier to health, therefore only those that can afford to pay for the programme do so, the programme is fully subsidised for those who cannot pay for the services available. Currently, 75% of THRIVE user pay £25 per month and 96% of them believe the programme is good value for money, and are willing to keep paying for the benefits they receive.
The Future of social prescribing
In areas such as Lorn and Oban where social factors play a significant role in the wellbeing of individuals, we have seen the Healthy Options programmes help reduce the need for GP visits. Social prescribing can be crucial in supporting communities across rural areas and help the country live up to their title given by WHO, as pioneers for their global campaign of physical action. By introducing new referral methods for THRIVE, our programme has supported more people and boosted the social prescribing offer across the region. Having the right software has been essential to the success of Healthy Options, and the Access Elemental Social Prescribing’s platform is key to helping monitor the benefits and track patient outcomes. As awareness for social prescribing and the avenues through which patients can access it grow, we hope to see the Healthy Options model become a go-to pathway, not only for people with long-term conditions, but also for those wanting to prevent them.