Introduction

TPHC were commissioned by London Borough of Tower Hamlets (North East London) to undertake a ‘Systemic Review of Social Prescribing and Connector Roles in Tower Hamlets’ in March 2024. The intention behind the work was to map provision and surface recommendations that might enable a whole system approach where similar roles are considered holistically and can work together more effectively.  

The specific aims of the review were to: 

1. Set out the model of SP and other closely related connector roles 
2. Build on existing mapping to understand the range, type and extent of services, where they are located and how they were delivered
3. Review strengths and weaknesses of current arrangements for how these services are delivered
4. Review strengths and weaknesses of SP and related connector roles
5. Outline what best practice could look like based on the learning from local, regional and national models

Key impacts and achievements 

• Endorsement of the top three recommendations, brought to the THT Board;  
  • Generate better, more consistent data by investing in a digital platform designed to support this work (Joy App)
  • Explore ways to better manage the levels of demand on SP services
  • Develop a Strategic Steering Group for Social Prescribing and all Community Connector Roles 

• Commitment from the Place Based Partnership, Tower Hamlets Together to identify funding and resource to implement Joy across a number of services taking a SP approach in the borough

• Information collated & mapping across the borough: A repository of information about each of the services, the range of stakeholders and policy and assets relevant to this work have been collected. This has been handed over to London Borough of Tower Hamlets Public Health and Integrated Commissioning teams, the commissioners of this review

• IMD map illustrating community connector and personalised care provision across the borough developed and shared as a prototype

• Created a multi-stakeholder forum – Seven meetings were held, with 25 individuals from a range of organisations joining (commissioners, public health, operational leads for connector services, PCN Network Managers, population health leads, the CVS, VCSE organisations, residents hubs, the advice sector and so on). It created a space for key, representative stakeholders to discuss the challenges and opportunities and help shape the work throughout

Why was this work important?  

Organisations in Tower Hamlets have a long history of employing social prescribing and connector approaches to address health inequity, and over the years, several services have evolved to prevent serious illness and improve the general health and wellbeing of the local population in this way.  

In Tower Hamlets, alongside the Social Prescribing Link Workers funded by PCNs and the ICB in general practice, there are also ELFT funded services supporting people with chronic conditions affecting people’s physical and mental health putting them at risk of secondary care admission, and public health funded roles proactively engaging with communities in areas of particular deprivation.  

Collectively these roles serve to support major national agendas such as the Department of Health and Social Care’s Major Conditions Strategy, the NHS’s Long-Term Plan and implementation of recommendations from the Fuller stocktake, and locally support all seven of the borough’s place base partnership, Tower Hamlets Together’s priorities for action.  

Whilst excellent work is being done across these services, there is a rationale and appetite for better coordination across them and an ambition to develop a borough wide, strategic approach for this agenda. 

Partnerships, networks and funding 

In consultation with a range of stakeholders close to this work, in recognition of the fact there were a number of roles providing social prescribing (if not in name), it was agreed the scope for the review would consider the roles that are taking social prescribing approaches as a core function of their work. These roles were agreed upon and will be referred to collectively as the ‘community connector services’ 

• Social prescribing link workers (any setting/funding)  
• Care navigators (ELFT) 
• Mental health community connectors (ELFT) 
• Community navigators (Public Health)  

Where time has allowed, some additional work has been done to map the broader personalised care roles in primary care (care co-ordinators) and explore other services in the system where there may be some overlap (in social care, council services and the VCSE) where possible. 

Over 100 people were engaged directly in this review, through a range of structured interviews, informal conversations, sharing of information, and group discussion. This does not include the various meetings this work has been taken to (such as the Living Well and Localities and Neighbourhood boards). 

Main outputs   

Three main non-public facing outputs were developed: 

1. THT Committee report – high level paper for the THT board outlining the work  
2. Report highlights – high level report that accompanied the THT board paper offering further information and findings to support key recommendations  
3. Final report – In depth report of the full findings of the review 

The activities during the work were: 

Engagement 

• Service and stakeholder mapping: gathering information about what is being delivered across the borough and contacts connected to the agenda

• 1-1 interviews:  Over 65 people engaged in the work via 1-1 conversations (in some cases group conversations of up to 3), with over 30 people interviewed on thoughts, experience, views and opinions of services and the system as a whole, as well as the development of case studies of what is working well elsewhere

• Online surveys: 51 responses from an online survey exploring the type of work being provided, the challenges in delivering some of this support and the opportunities to work more cohesively as a system

There was an additional survey for operational managers and prominent individuals from the Tower Hamlets Network to explore further their views on a digital system to support community connecting (11 responses)

• Group work & team meetings: developed a multi stakeholder group that met monthly to help shape the work and joined several key meetings (including a PCN network managers meet; the Living Well, Tower Hamlet’s Together and Neighborhood and Localities boards) to present and discuss the work

Synthesis

• Consulting key stakeholders in the development of a series of recommendations that would enable the future development of a borough-wide strategy for social prescribing

Full handover to enable implementation

• One of the recommendations was to ensure there was someone whose role it was to ‘convene’ the breadth of stakeholders in the borough around this agenda. The Public Health team commissioning this piece of work opted to take this on.  A full handover of the research, documents and insights generated through the engagement and a guidance document (proposed action plan) for next steps was handed over to the team, with a ready-made, engaged stakeholder group that were in support of continued, borough-wide engagement on this agenda