The pandemic has highly impacted people’s health and wellbeing, due to changes in many people’s financial stability. London Plus spoke to the Bromley by Bow Centre about the important role of social prescribing in connecting health and advice.

How can social prescribing and social welfare advice work together?

There is significant overlap in what social prescribing and social welfare advice try to achieve. Both address social issues which impact people’s lives and health.

There has been much work on the health impacts of social prescribing. This includes a body of literature on the benefits of integrated social welfare advice in health settings[1]. However, the relationship between the two services has hardly been examined.

Social prescribing has a key role in connecting health and advice, according to The Bromley by Bow Centre.

Background

The Bromley by Bow Centre initially set out to understand the implications of co-locating the two services prior to the pandemic. This was with the support of the Greater London Authority and The Legal Education Foundation.

We found that there were huge benefits of the services working together, particularly in primary care. This has helped to create a culture shift towards a focus on the social determinants of health. However currently only around 1 in 10 GP practices has on-site social welfare advice sessions.

However, there were also certain challenges and obstacles to collaborative working. It was clear that to obtain the maximum benefit from collaboration, certain conditions must be fulfilled.

Through the course of the pandemic, working and living conditions have shifted beyond recognition. This has opened up questions on how collaborative working can occur when, often, co-location isn’t an option.

Bromley by Bow Centre released a report in January 2021 that explores both the pre-Covid and Covid experience of services.

It made a number of recommendations on how collaboration between social welfare advice and social prescribing can be supported across London.

One recommendation was to broaden the definition of care to include support, to meet minimum living standards. Another was to improve the support infrastructure.

Following this report, we undertook further information-gathering, building up case studies of good practice. We also developed an understanding of the challenges facing social prescribing services regarding advice-related issues.

Our Conclusion

The Bromley by Bow Centre’s report highlighted many creative examples of partnership working.

We had found a hugely mixed picture. In some areas, as demonstrated by the case studies we compiled, there were really creative examples of partnership working which extended beyond co-location of services, with effective collaboration and integration.

The pandemic had expedited and created many of these partnerships. These include the Social Welfare Alliance in Newham, hybrid social welfare advice social prescribing roles in North Islington and integrated working between teams in Barking and Dagenham.

In contrast, the pandemic exposed the impact of years of reduced funding to advice services in many areas. Often, social prescribing link workers were left to pick up the pieces. Link workers reported rising demand and increasing complexity of need, with increased difficulty accessing appropriate statutory and voluntary sector services.

Worryingly, 89% of link workers who attended our March webinar reported that they were supporting people with advice issues beyond their training and competency. Social Prescribing schemes also reported that 50% to 80% of the clients they were seeing had some social welfare related issue. Additionally, 87% of attendees at the webinar reported an increase in need. Evidently, we cannot ignore these challenges.

It is the prescribed medicine that leads to the cure; not the prescription. We must acknowledge this within social prescribing. The under-resourcing of advice services in London risks jeopardising the achievements of social prescribing schemes, clinicians and the voluntary sector.

We must use our voices and leverage to address this. This can be by securing local, pan-London and, eventually, national commitment to social welfare advice provision across primary care. Only through this joined-up approach can we begin to see our healthcare system address the social determinants of health meaningfully.

[1] See the slide deck summarising existing research here.

Find out more

Read the Bromley by Bow Centre report on collaboration between social prescribing and social welfare advice released in January 2021.

Watch a recording of the seminar held in March 2021, and read more about the research gathered by the Bromley by Bow Centre and the PhD candidate Sarah Beardon.

We’d like to hear from you!

The London Social Prescribing Network is looking for more case studies like these. If you’re a small organisation filling an unfunded social prescribing gap, please contact us to get your voice heard by those with a key role in supporting the sustainability of social prescribing activities.