ForViva Connect Residents to Community Services Using Digital Social Prescribing

THE NHS FIVE YEAR FORWARD VIEW IDENTIFIED THE NEED FOR HOUSING, HEALTH AND CARE TO WORK TOGETHER IN THE DESIGN OF FUTURE SERVICES. WITH HEALTH STARTING AT HOME, HOUSING ASSOCIATIONS PLAY A VITAL ROLE IN REDUCING HOSPITAL ADMISSIONS, LENGTH OF STAY, DELAYED DISCHARGE, READMISSION RATES AND ULTIMATELY IMPROVING HEALTH OUTCOMES IN COMMUNITIES.

One housing association leading the way is ForHousing, part of ForViva group based in the North West, delivering housing management services to around 5,500 Cheshire West and Chester Council owned homes in Ellesmere Port, Neston and Winsford.

Using Elemental’s Core social prescribing platform, ForHousing has linked existing social prescribing projects with a local GP and housing officers to address social issues such as financial problems, relationships, employment and housing.

PASSPORT TO WELLBEING

Now, GPs in the area are referring patients directly to social prescribing activities and increasing the numbers of residents accessing and engaging in ForViva’s Passport to Wellbeing pilot which includes relaxation programmes, Nordic walking, healthy eating sessions, counselling and Wednesday’s lunch club, to address isolation.

One of the major aims of Passport to Wellbeing is to avoid high-cost public service intervention such as an acute hospital admission, which costs around £450 a day.

CONNECTING PATIENTS TO THE CARE PATHWAYS IN THE COMMUNITY

Dr Rajesh Rajan, a clinical director making instant social prescribing referrals said “This is one of the poorest areas in Cheshire and nationally it has high rates of poverty-related factors, like depression and social isolation. Being able to put people in contact with these other services gives me an extra choice, another route for the patients.”

Via Elemental’s social prescribing technology, Dr Rajan can ‘prescribe’ social activities in the same way he would medicine, enabling patients to address the root cause of their issues and empowering them to manage their own health and wellbeing.

The social prescribing software also allows clinicians to monitor and track the progress of the referral, so that they can provide enhanced support to further assist an individual.

SOCIAL PRESCRIBING IN ACTION

Jenny Chapman, group director of innovation and excellence at ForViva said “What GPs have is a very limited time to be able to spend with someone who is presenting as a patient. Now, with a single click, Dr Rajan can send the patient’s details to the housing association, which then follows up with the tenant.

Perhaps it is Mr Jones who goes to his GP and says, ‘Actually I don’t get out very much and I think it is making me feel a bit depressed’. We can give Mr Jones a number of options for engaging with different agencies; he agrees and that agency will then contact him. All of that information stays in one area, so if Mr Jones goes back to the GP, the doctor can see he’s gone to the lunch club and ask how he’s feeling about it.”

EMPOWERING PEOPLE TO EMPOWER THEMSELVES

Working with the residents, Link Workers help to identify suitable social prescribing programmes and services, before building a personalised social prescription suited to their wants and needs of the individual.

Mandy Welsh is one of those who has benefited. She had been experiencing some problems with anxiety, which left her struggling to leave the house or deal with her financial situation. She has now been referred to Trinity Church and has been going along to the Wednesday events. “I was anxious about going but I found a table in the corner, out of the way, and that helped,” she says. “I’ve met people there, which has been nice.”

NOT DIGITAL FOR DIGITAL’S SAKE

Jenny Chapman, ForViva’s group director of innovation and excellence discussed the partnership with Elemental “This is not digital for digital’s sake: it is a technological solution that allows the very best of human relationships to be capitalised. The platform is never going to replace the human touch.

What it does do, however, is give ForHousing another, potentially simpler way to help keep vulnerable tenants in their homes, make sure they are not admitted to hospital, or enable them to get support before their problems become acute. If we aren’t supporting people to retain their tenancies, then we aren’t doing the role of a landlord.”

Currently, the pilot has a cap of 200 people, with four agencies on the platform, all in Ellesmere Port. However, there is potential to roll out the project across Knowsley, Oldham and Salford.

REGISTER FOR OUR FIRST HOUSING WEBINAR OF 2019

Join our host, ForHousing Wellbeing Lead for Cheshire West, Toria Buzza, and Elemental Co-founders Jennifer Neff and Leeann Monk-Ozgul as we establish where you are in social prescribing, define the next steps to get you started with social prescribing, and the benefits of using digital to enhance your existing programmes.