"TOWN DIGITAL HUB TAKES A UNIQUELY HOLISTIC APPROACH TO SOCIAL PRESCRIBING."
Dr Richard H. Kimberlee,
South West Lead,
NHS Social Prescribing Network
Even in developed economies, low quality of life is widespread, and public services such as healthcare, social care, policing, justice, education, housing, and transport are not coping with:
Growing mental health problems, that it is not proving effective to treat using medication alone (antidepressant usage in the UK doubled between 2005 and 2016 despite 78% of GPs believing an alternative treatment would be more appropriate) or by addressing spurious physical symptoms (Medically Unexplained Symptoms cost the NHS £3 billion per year, which is £50 for every man, woman and child in the country)
The care needs of a population that is aging and seeing a general rise in long term conditions, for which purely professional help is not cost effective or even desirable
People staying in institutions such as hospitals for unnecessary periods, when they would be better off in a home environment with appropriate support
The integration of recent immigrants and others isolated from society into a caring, sharing community support network
The NHS is investing in social prescribing, but recent research casts doubt on the effectiveness of current approaches. There is a high drop-out rate for people with complex lifestyle issues (such as safety, addiction, finance, housing, and transport), who cannot learn to manage their own wellness holistically without long term help. Such clients still have poor quality of life and make extended use of public services.
The problem is particularly acute for people transitioning from a major life change such as bereavement or discharge from an institution (armed force, prison, hospital, children's home, detention centre, or educational establishment). Services that aid such transition have limited resources, which they could make better use of by changing focus from delivery of one-off recommendations to coordination of sustained volunteer support.
People with simpler issues (such as isolation, weight, and fitness) may use community assets for a time, but often this is only temporary and many also request professional mental health services from the start. So even for these clients, the evidence for overall reduction in public services costs is weak.
The people with lowest quality of life and highest system cost need to become activated in managing their own wellness.
At the same time, the potential value of volunteer effort is huge. The Bank of England has calculated that in the UK it is worth £50 billion per year in terms of effort alone, which is about 3.5% of GDP. Volunteers themselves receive a range of benefits equating to another £50 billion of value. And the social welfare benefits are at least twice the total, making the net value to the UK economy upwards of £200 billion per year, or over 14% of GDP.
People with complex issues need personal, sustained help to change their lifestyle, and this could be provided by other local people who have learned how to manage their own wellness. So volunteer effort could potentially provide the coaching and mentoring necessary to improve quality of life for those most in need. However, few communities have a systematic, structural way to let this happen.
Someone with wellness issues, who relies on a combination of public services and community groups for support as well as on family, friends and neighbours.
I am trying to get my life back on track. How can I make a long-term wellness plan, including the personal network (family, friends, and neighbours) and service providers that I rely on?
Before Town Digital Hub: I am trying one thing after another as they are recommended to me, without knowing how it all adds up to sustained, holistic improvement to my lifestyle.
With Town Digital Hub: My service providers have helped me make a lifelong wellness plan online - I am learning how to manage this for myself, and feel that I am on an upwards path.
I am working with a service provider. How can I share with the service provider the personal information and activities I have already set up with other service providers?
Before Town Digital Hub: I am filling in the same information on forms for each organisation that tries to help me, and spend far more time doing this pointless activity than on receiving any help.
With Town Digital Hub: All those who support me, including selected family, friends, and neighbours as well as service providers, can see my wellness plan so I can update all my information in a single place online and everyone will know.
I am facing a crisis. Who knows what is happening to me and is in a position to help?
Before Town Digital Hub: No-one knows the whole picture about me, so any attempts to help me will be disjointed and ineffective - in the end, I am on my own.
With Town Digital Hub: My service providers and personal network know all about me, and about each other, so will work together effectively to help me deal with this situation.
A public services organisation (healthcare, social care, fire, police, justice, education, or other council funded services such as housing) or community group (whose activities might be anything from befriending to fitness).
I am promoting our services. How can we communicate our outreach activities to community members and allow them to sign up?
Before Town Digital Hub: We are bewildered by all the websites out there, and none of them allow potential clients to interact with us.
With Town Digital Hub: We have use of a free online platform that lets us promote our activities, offer tickets for appointments and events, seek volunteers, and reach the community via targeted social media.
I am supporting a client. How can we collaborate effectively with the other service providers supporting the client, and with their personal network (family, friends, and neighbours)?
Before Town Digital Hub: We don't know else who is working with our clients, how to liaise with them, what information they are capturing, or how to make a shared action plan for each client.
With Town Digital Hub: We can see everyone who supports our clients in their life journey, what they are doing for the clients, and know how to contact them in order to work together.
I am reporting outcomes to funders. How can I collect all the data our funders require, which is slightly different in each case?
Before Town Digital Hub: We are subjecting our clients to endless form filling, which frustrates them, generates administration costs for us, and doesn't do anything to improve clients' situation.
With Town Digital Hub: Our clients are learning to use specialised forms of online self-assessment as part of managing their wellness plans, which delivers personal value to them while automatically providing us with the data that we need for funders.
Organisations that commission services include councils, NHS Clinical Commissioning Groups, police forces, charities (trusts, lotteries, and so on), Corporate Social Responsibility business units of corporations, and more.
I am safeguarding community members.
Before Town Digital Hub: How can we curate the services we offer the community to ensure they are reputable and safe? For all we know, community members could be accessing unethical, dangerous, and unnecessarily expensive services.
With Town Digital Hub: Anyone in our community can submit new services online, but we have control over which services appear in their local digital hub, and how they are targeted.
I am investing into community infrastructure.
Before Town Digital Hub: How can we make smart investment decisions, for example to target gaps and overlaps? We have vast amounts of detailed data to work through, and none of it tells us what we need to know.
With Town Digital Hub: We have simple pivot tables that let us see at a glance what is working and for whom - we can download these, then slice and dice them for use in reports.
I am reporting to senior management.
Before Town Digital Hub: How can we justify our investment decisions with data on effectiveness and efficiency? Our investment decisions are based on personal recommendations and educated guesswork, so we are not acting responsibly on behalf of the community - our jobs and reputation are at risk.
With Town Digital Hub: We know the sorts of people using each service, the impact on their wellness, and the consequent reduction in public services costs, so we are confident that we are using our money as well as possible in the public interest.