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Feedback - Social Prescribing Network (SPN) Manifesto

Dear member of the Social Prescribing Network,
the steering group of the Social Prescribing Network has drafted a social prescribing manifesto to clarify the role of the Social Prescribing Network in relation to the current and future development of social prescribing. We drafted this from a UK perspective, but tried to ensure that it is globally applicable too.

We now seek your feedback in finalising this manifesto so that we can appropriately represent the wider membership base of our network. This applies to all our members from users to commissioners.

Your responses are collected anonimously. We will ensure that your personal details and opinions are not shared outside the social prescribing steering group.  

Any comments or suggestions are highly appreciated! thank you very much in advance for your help with this and your continued to support to social prescribing and the Social Prescribing Network 

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* 1. What is your role within social prescribing?

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* 2. If you are a healthcare professional, is your role one of the following?

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* 3. If you are a link worker, or work in that role, are you employed by a GP practice?

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* 4. How long have you been member of the Social Prescribing Network  approximately (months)?

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* 5. What home nation of the UK do you live in?

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* 6. What we believe
Social prescribing works

We believe (and have lots of evidence to support this view) that social prescribing link workers can facilitate life-transforming interventions. The key elements of these interventions are incredibly simple, though delivery is often complex in time- and resource limited public and voluntary sector services. It requires:

  Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree
Time for a social prescribing link worker to work with the person on what matters to them in a way which alloes them to gain or regain a sense of control and purpose and address the challenges they face
A quality assured process for referral and access to social prescriptions in the persons local community

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* 7. What we believe
Community is crucial

  Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree
We believe community provides a wealth of social networks that can be harnessed for health and wellbeing, and that for  social prescribing to work well there has to be a well-resourced Voluntary, Community, Faith and Social Enterprise (VCFSE) Sector
We believe commissioners must value and fund the VCFSE Sector to work in integrated partnership, so that people can easily access the varied support and help to stay well 
We believe health creation comes from within communities; from people’s environments and relationships not predominantly from what the NHS or formal healthcare services do
We believe social prescribing has a key role in helping people (re)connect with their communities but it also helps individuals and communities to be heard by the services that are there to support them
We believe the healthcare system needs to treat the VCFSE as an equal partner in relation to the role of the NHS and Local Authorities
We believe the healthcare system needs to better understand and recognise the value of the  intelligence based on local lived experience that the VCFSE brings to the table

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* 8. What we believe
Asset based working within communities

  Strongly Agree Agree Neither agree nor disagree Disagree Strongly disagree
Social prescribing is an 'asset-based approach' defined as 'Any resource which increases the ability of individuals, groups, communities, and/or institutions to maintain health and wellbeing and to help to reduce health inequalities' (Morgan and Ziglio, 2007)
Social prescribing link workers help to connect a person to something that matters to them in the community
Social prescribing emhasises the 'positive' building of community assets (institutions, buildings, individuals, and networks)
Social prescribing focuses on the importance of 'place' 
Social prescribing is focussed on creating or untapping 'agency' in indviduals or groups by working together to build critical consciousness leading to individual and social transformation

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* 9.  What we believe
Following the 'what matters' conversation from introduction to activity

  Strongly agree Agree Neither agree nor disagree Disagree Strongly Disagree
Successful ‘soft transfer’ to a social prescription by a social prescribing link worker
Asset mapping and building relationships with local community including, crucially, the VCFSE
The link worker role is key in helping local change happen, including connecting communities and helping them access funds, thus adding value to the referral system 

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* 10. What we believe
We need to socialise medicine, not pathologise distress

Western medicine has achieved amazing results.  But it also risks becoming an industrialised and depersonalised model because of the pressures on clinicians and the structures that influence their behaviours.  We believe that to address overprescribing and over-reliance on formal clinical care:

  Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree
We need to give people access to much better quality conversations about their health and wellbeing
They need to be able to access social assets as well as formal clinical care
Medication and formal treatments need to be part, not the whole response, with the patient being in control

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* 11. What we believe
Better quality conversations and ‘co-production’, that is working with the person on what matters to them to develop solutions

This is as true in secondary care as it is in primary care.  There is a growing evidence base that many people accept being ‘put on the conveyor belt’ for treatment without having had alternatives or risks fully explained (or time to understand them).

  Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree
We believe social prescribing can be a significant part of changing this culture, empowering both the clinician to share power more effectively and the patient to ensure the treatment is the right one for them

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* 12. What we believe
Navigation and interpretation

Citizens (and many professionals) speak of the ‘system’ being like a maze and needing help to navigate it.

  Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree
We believe that social prescribing has a critical role in reducing the stress that can be caused by responses from an often confusing and bureaucratic system 
Simple and clear language is important
Simple guides to how things work are crucial for citizens but also actually make it easier for professionals in the many roles that exist across the system to work together more effectively

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* 13. What we believe
Make it easy

  Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree
The ‘system’ talks constantly in complicated language about overlapping paradigms that look at things through the prism of personalisation, health inequalities, prevention, population health management and other system-led ways of thinking
Social prescribing starts with the person and makes the system fit around them, rather than the other way around
We believe that social prescribing is the 'oil' which makes the machine work more smoothly

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* 14. What we believe
Integration

Professionals sometimes talk of integration as if it was an innovative aspirationMost citizens are bemused that their taxes are not paying for a fully integrated system already and are shocked that professionals are not working together effectively.

  Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree
We believe that social prescribing link workers can make an unique contribution to integration by helping people to understand and manage the complexities they are faced with
Social prescribing can improve the link between primary care and community, but also between hospital and primary care for those waiting for operations or needing support at or after discharge
Social prescribing should be available wherever in the system it becomes evident that you are having problems, whether that is with NHS, housing provider, neighbours or family
Social prescribing is about you having the best quality of life you can, it is not primarily about the system
We also believe that social prescribing, if it is allowed to have the right level of influence within systems, can be a crucial catalyst for the systems to learn how to integrate better and more generally.  This is because social prescribing wraps around the person, rather than expecting the person to fit themselves into the different structures of a non-integrated system

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* 15. What we believe
Commissioning

  Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree
We believe that organisations planning and purchasing healthcare for their local populations (e.g. Integrated Care Boards in England) must commission the VCFSE in a joined up strategic way
This must include the evidence about how the wider determinants of health negatively affect people’s health and the role of the VCFSE in addressing them
This should also include addressing perverse incentives that drive people to seek clinical solutions for lack of easy to find social ones
Commissioning must ensure full cost recovery for the VCFSE and must be flexible enough to allow for flexibility and innovation in the VCFSE’s responses to community needs
It should encourage collaboration, maintenance and development of community assets rather than competition  
Commissioners - and other organisations who plan and purchase services -  should give users voice in the way social prescribing schemes are developed and implemented

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* 16. What we believe
No wrong door

We want people to have an easy pathway from experiencing a problem to getting the support they need. 

  Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree
This requires good community information, fully accessible in a range of formats and an integrated VCFSE working together to ensure people can get the right mix of support
Social prescribing can then focus on helping those facing the greatest challenges to access that support

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* 17. What we believe
Links to change in health inequalities and advocacy

Because some people facing the greatest life challenges cannot easily ask for help or even believe that there may be help for them:

  Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree
We think more resource should be put into proactively reaching out into some of our communities, and social prescribing is a key tool to help this happen
Reaching out to people facing health inequalities through population health management approaches
Addressing the issue of polypharmacy (i.e. prescription of multiple medications - up to 10- inappropriately), a particular problem for people with Multiple Long Term Conditions 

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* 18. What we believe
Proactive Social Prescribing

Proactive social prescribing provides targeted outreach support to a group of people with an unmet need. Proactive social prescribing may involve identifying a specific cohort of people through primary care databases and for link workers to contact them directly so that they do not need to be referred by a healthcare professional. This may help to reduce visits to primary and secondary care and reach under-served groups more effectively.

  Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree
Proactive social prescribing may help with identifying a specific cohort and target support to them
Proactive social prescribing may help with tackling areas of health or social need that deserve special attention in a specific geographical area
Proactive social prescribing may particularly help people who attend primary care frequently for social reasons
Proactive social prescribing may help address health issues of people who do not currently have confidence to come forward for needed medical help

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* 19. What we will do as a network

  Strongly agree Agree Neither agree nor disagree Disagree Strongly Disagree
Encourage you to join us if you share our beliefs and values
Support, share and work with anyone nationally or internationally wanting to promote or deliver transformative social prescribing in line with the values outlined above
Challenge practice which looks to produce a watered-down version of social prescribing which does not live up to the beliefs described above
Share evidence of best practice and support people working to develop and spread innovative ways of using the social prescribing model
Continue to lobby for the proper acknowledgement of the value and the need to support a thriving voluntary, community, faith and social enterprise sector.

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* 20. The statements above are what we have come up with by way of the key principles underpinning social prescribing. Do you think are there any others missing?

0 of 20 answered
 

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