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Garry Jones's blog

Tue 16 Jul 2019

As I write we are in the depths of discussions with PCNs (Primary Care Networks – clusters of GPs, working together) about the opportunity provided by national funding for social prescribing link workers. Ourselves and VAST have pitched a bold proposition to place this service at the heart of the local voluntary sector, by employing the workers through a consortia approach. This would mean generalists working for ourselves and VAST, able to signpost and support patients to access the broadest range of community and voluntary sector services; instead of drawing upon medical services. But crucially, and growing over time, we would work with our members to harness their expertise in mental health, older people, learning disabilities, end of life care and much more; and yes this means resources and you employing the workers.

Our ambition is to build a voluntary sector led team of link workers, with the right mix of knowledge, experience and connections to the huge potential of our sector. We are also resolute in our campaign that the services or ‘prescriptions’ if you will, must also be funded, especially as demand upon them grows – you wouldn’t expect a drugs company to give away its medicines for free!

I know this sounds ambitious, and I’m not naïve enough to believe we will succeed straight away.

In fact there are already signs of some PCNs, taking a more direct approach and employing mental health workers or engaging mental health charities to ‘just do’ the work direct. I can understand the temptation of this ‘route one’ approach, especially when GPs face such a demand from their patients right now. But I believe this is short-sighted, and wont ultimately achieve what the whole Health & Care system is seeking.

Instead we need a collaborative approach, which breaks down barriers and disrupts the old competitive mind-set both within the NHS and the voluntary sector. If what we are seeking is a community approach, where people look after themselves, their families and their neighbours more, we can’t start by putting more voluntary sector services into neat and tidy boxes; and which categorise patients largely by their condition. It would be regrettable indeed if the social prescribing initiative were to falter at the first hurdle by taking such an approach – medicalising what are social issues, categorising them, systematising them.

Individuals are complex collaborations of social factors; from work, to friends, to family to mental health, pets, diet, exercise, environment, parenting, relationships, education and so much more – to support those patients who are manifestly unwell by addressing one or two of this issues in isolation, completely misses the point.

So I call on GPs and the sector to work together on this; and together we can make a fundamental change.