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Unlocking the full potential of voluntary care

Dr Nikita Kanani, Chief Clinical Officer for NHS Bexley Clinical Commissioning Group, explains how working with the voluntary sector to offer social prescribing services is helping to transform the lives of people in Bexley

In Bexley, both health and social care services have been working together to explore innovative ways of working with the voluntary, community and social enterprise sector to combat problems that can be described as ‘wider determinants of health’. These include factors such as loneliness.

As a result, in October this year Bexley Voluntary Service Council, in partnership with Mind in Bexley launched Community Connect, the new borough-wide social prescribing service. Free to anybody over 18 years old and registered with a Bexley GP, Community Connect will ensure people with non-medical problems receive the help they need to stay fit and well. Problems that the service can help with include isolation and/or feeling lonely; financial or housing issues; support with a recent medical diagnosis; dealing with stress and anxiety, and substance misuse (either their own or a relative’s).

We know the service has a role in Bexley, as it’s been piloted for the best part of a year, with volunteers seeing around 10 to 15 people each week. Age-related health conditions and loneliness are common topics of conversation and users are clear about the impact the service makes.

We’ve heard really positive accounts of how the service is changing people’s lives. One Bexley resident, Sylvia Jaques, describes her husband as a “different person” thanks to the help and support they have both received from the social prescribing team in Bexley. She has explained how her husband John has “transformed from a man who just wanted to stay in bed all day into someone who is up and out in the morning”.

Thanks to social prescribing support, Mr and Mrs Jaques have been able to join in a range of services for people with memory problems, including activity groups, summer day trips, and recently, Beat for dementia exercise classes. More practically, there have been referrals in relation to attendance/carers’ allowances and respite services.

As a carer, Mrs Jaques says she has benefited from the support of others in the same position: she now knows that she is “not alone”. She has developed a wonderful support network of other carers, who exchange tips and hints on where to go and what to do when anyone needs help. Social prescribing, she says: “has worked wonders for everyone”.​

So why have we launched this service? In the UK today, there are estimated to be more than one million people aged 65 and over who are chronically lonely. Seventeen per cent of older people speak to their family, friends and neighbours less than once a week and 11 per cent less than once a month. Within the trend of rising single-person households, more than half (51 per cent) of all people aged 75 and over live alone. An indicator of the atomisation of many older people’s social world is that two fifths of all older people (equating to some 3.9 million people) say that television is now their main source of company.

Loneliness is a problem that goes beyond a painful emotional experience; it’s well known to be harmful to our health, with a greater impact than well-known risk factors such as obesity and physical inactivity, and as harmful as smoking. It’s well known that lonely individuals are more likely to visit their GP, undergo earlier entry into residential or nursing care, and be admitted to accident and emergency services. As a GP all too often I see the physical manifestations of loneliness including high blood pressure, and know that lonely people are at a greater risk of developing dementia and depression. It’s clear that loneliness has significant cost implications for the NHS, social care and the wider economy.

In my opinion, social prescribing is the perfect antidote for many.

Sustainability and Transformation Plans (STPs) now in development across England recognise the importance for the prevention agenda of the so-called wider determinants of health, which include factors such as loneliness. As healthcare commissioning becomes more place-based and moves towards population footprints and STPs, the role of charities and social enterprises arguably becomes even more important. Put simply, none of the STPs will be able to meet the objectives of their plans if they do not better engage with citizens and work with and through the social sector”.

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Healthy London Partnership has launched a new guide to support commissioners to work with the voluntary, community and social enterprise sector. Download the guide.

For more information about the guide and this work email jemma.gilbert2@nhs.net

We have also published a guide to support commissioners to implement social prescribing locally. Download the guide.

For more information about our work to support social prescribing in London email j.barnacle@nhs.net

About the author

Dr Nikita Kanani is a GP in south-east London and chief clinical officer for NHS Bexley Clinical Commissioning Group (CCG), where she is responsible for leadership of the governing body and strategic development of healthcare locally.

Dr Kanani has held a range of portfolio positions within the CCG to support the development of mental health services, integrated care, primary care, clinical leadership and patient/public engagement. She is passionate about improving service provision and population health within the NHS and has managed and taken the lead on numerous projects that reflect this. Among her many responsibilities, Dr Kanani is the senior responsible officer for the new models of care work stream as part of the south-east London Sustainability and Transformation Partnership (STP).