Paul* was struggling with anxiety and depression. In his fifties, he has dyslexia and is on the autistic spectrum. He also has post traumatic stress disorder, following events in his life. “I wanted to get some direction,” he said, “to find the services that would benefit me. Because of my dyslexia, I needed help in filling in forms and I couldn’t find anyone to help me as I am on my own.”
He was referred for five social prescribing telephone calls and one face-to-face session. As well as receiving practical support, he was put in touch with the counselling service, Merton Uplift, the social welfare charity Wimbledon Guild for bereavement support, and the local branch of Mencap for social activities.
Nobody had listened to me before I had bereavement counselling. For the first time I’m talking about my childhood experiences.”
For Paul social prescribing has brought clarity. “It has given me peace of mind, put ideas in my head, suggestions – to be a bit more sociable as I am not a very sociable person. And to help me sort out information and what is going on in my mind.
“Nobody had listened to me, before I had bereavement counselling. For the first time I’m talking about my childhood experiences.”
Social prescribing is a simple yet transformative idea that addresses the non-medical issues, which have a profound effect on people’s physical health and wellbeing. These range from loneliness and isolation to debt and housing problems. Dedicated link workers in GP practices connect people to local services, supporting them to address their own needs.
Merton has been at the forefront of the social prescribing movement for many years. So, it’s no surprise that two of the borough’s practices, in Pollards Hill and Raynes Park, have been selected as the focus of a review by the University of Oxford into the role of social prescribing in helping GPs manage rising demand.
Merton Connected, the borough’s community and voluntary sector hub, provides the service in GP practices. Ben Halschka, who manages the programme, explained how it works. “During the first consultation we try to make referrals on the spot; so already people can see things being done for them. Some patients just need to be seen once and that’s it. Others, who return, may have hourly sessions, depending on their needs.
“Sometimes they’ve lived in Merton for their whole life and aren’t aware that there is an activity or group for them, because they have a certain hobby or speak a certain language. Merton is a very small borough, but there are 800 services and activities in our directory. There just needs to be a connection.”
Merton Connected uses local health data to understand the social prescribing referrals that are being made and identify gaps in support. Its wealth of knowledge of the local voluntary sector means it can help groups fill those gaps and access funding sources, in some cases.
People referred for social prescribing can also join mutual support groups. Says Ben, “On a Monday we meet at the National Trust’s Morden Hall Park. The group is open for all local social prescribing patients and we have people aged from 22 to 81, from all walks of life. Our patients’ WhatsApp group chat enables them to connect and support each other. It doesn’t cost anything, and it brings so much joy.”
The results of social prescribing speak for themselves. According to pre-Covid data, patient wellbeing scores increased by more than 77% after sessions, based on standard ONS questionnaires. The service has also led to a 33% reduction in the need for GP appointments by social prescribing patients and a 50% reduction in attendance at A&E.
Pre-Covid it was mostly isolation, loneliness and physical wellbeing. That’s still the case, but we are also seeing financial difficulties and homelessness.
Among the top reasons for referrals are mental health issues and isolation, followed by more practical needs. Has the pandemic changed that? Says Ben, “Pre-COVID it was mostly isolation, loneliness and physical wellbeing. That’s still the case, but we are also seeing financial difficulties and homelessness.
“We’ve seen an increase in referrals for isolation among those of working-age. People assume because you have a job in the city or you are a professional you that you don’t feel lonely, but that’s not the case. Some people work full-time and are quite young but still they don’t know how to connect.”
Carol* had suffered ill health for more than 20 years. She was referred to a social prescriber, while experiencing depression during the pandemic.
It was good to have weekly contact, knowing someone was interested in supporting me and my needs.”
She said: “After having a happy and fulfilled working and social life, I have been suffering with several long-term physical conditions, including MS. I was shielding because of Covid-19 which very isolating, boring and made me feel so miserable plus I have ongoing pain due to my physical conditions.
“I was referred for a telephone appointment. The social prescriber called me every week. I must have had half a dozen calls with her. It was good to have weekly contact, knowing someone was interested in supporting me and my needs.”
“I think people get confused as to what social prescribers are for, or they think they are counsellors,” she said. “I think they can be a font of all knowledge and a good source of advice and information, especially for the local area. My link worker gave me lots of ideas, about doing online art activities and zoom classes, as I am living alone and pretty isolated. Also, she gave me information as I am on a low income and finding it difficult to pay my bills.’
“My experience is that the social prescriber has been a fantastic new addition to the surgery; professional, empathetic and at the same time chatty and friendly.”
It helps us get to the heart of health inequalities by directing people to the right support for them.”
According to Dr Mohan Sekeram, Merton GP and lead for social prescribing in the borough: “Social prescribing is vital to general practice on so many levels. It helps us get to the heart of health inequalities by directing people to the right support for them, whether counselling, debt management or employment and training.
“In the current climate, so many people have required support as a result of COVID and social prescribing has really helped address that. But, more than ever, it acknowledges that so many of people’s health problems have a non-medical origin. Addressing these things really does help lift the pressure on health services.”
Patricia* enjoyed life before the COVID-19 pandemic. She had a busy social schedule and a career in the travel industry. However, during lockdown she was unable to meet friends, lost her job and needed to live off her limited savings. As lockdown continued, she felt isolated, and struggled to sleep as she worried about the bills she was had to pay. She began to drink more than before and lost her motivation.
After booking an appointment with her GP, she was told about social prescribing and agreed to give it a go. Through social prescribing she was directed to community services including One You Merton for support to reduce her alcohol intake and make lifestyle changes to improve her sleep patterns, such as a morning exercise routine.
She was directed to Jobcentre Plus for welfare benefits and Citizen’s Advice for help with cutting her energy costs. She also used the Sunshine Recovery Café by for help when she was feeling low.
As restrictions lifted, she began enjoying time with her friends again and her aim is to get back into employment.
Find out more about social prescribing in Merton.
* The names of the patients in this blog have been changed.