Resources and Events – Case Studies

Hydebank Wood College: August 2020

About The Project

Located in the rural area of Belfast, Hydebank Wood College is a Category C prison with males (age 18-21+) and females (age 18+). In 2019 The Public Health Agency funded a social prescribing pilot study that involved a Multidisciplinary Team within the college. This team would support a group of female patients to better connect into the programmes and services that contributed towards improved health and wellbeing within the prison environment.

Background

Located in the rural area of Belfast, Hydebank Wood College is a Category C prison with males (age 18-21+) and females (age 18+). In 2019 The Public Health Agency funded a social prescribing pilot study that involved a Multidisciplinary Team within the college. This team would support a group of female patients to better connect into the programmes and services that contributed towards improved health and wellbeing within the prison environment. The project was extended and young males were also invited to take part in the social prescribing programme.

The Challenge

Hydebank Wood College wanted to create a mechanism for how they capture the things that mattered to the patients and better support those who suffer from anxiety, trauma and addictions through a range of non medical interventions within the prison. It was important for the healthcare in prison team to find out what the person was involved in and would like to be involved in when they leave.

A number of objectives were set around the challenge to:

  • Scope the current provision of non medical services that contribute towards health and wellbeing within Hydebank
  • Prevent the duplication of services
  • Ensure that the patient was supported to co design more ‘person centred’ wellbeing plans
  • Ensure suitability of service and engage multi-agencies as well as internal service providers
  • Focus more on Outcome Based Accountability
  • To commission future services based on the data generated from the project 
  • Link services through the gate

The overall plan was to lay the foundation for integrated care from all involved agencies and continue social prescribing through the gate and beyond.

100% of patients saw an increase in wellbeing via the Shortened Edinburgh Warwick Wellbeing Scale (SWEMWBS); this equated to an average increase in score 7.8%. Feeling relaxed and dealing well with problems were two of the measures that most people saw an increase in.  Feeling useful and thinking clearly were the next most popular.

The Solution

Elemental worked with the project steering group to co design the referral pathways with the patients. This saw the Mental Health team within Hydebank take the lead in identifying suitable patients and making referrals through Elemental’s social prescribing platform. Once the referrals were made to the Senior Nursing Assistants, each patient was supported to set goals, measure their wellbeing levels and were introduced to interventions that would help them achieve their goals.

The Nursing Assistants were able to map the services available and in one case, were able to design a programme of support around helping patients get to sleep. This was previously just a leaflet with tips and advice on establishing a good routine for sleep.

When I joined healthcare in prison, I was pleasantly surprised and excited to see social prescribing embedded within Hydebank Wood College.  Everyone involved knows the wider benefits of social prescribing and there was positive verbal feedback from providers and those within our care.  Elemental has provided a platform to enable us to manage social prescribing undertaken by the various agencies within our facility and to measure outcomes for the people in our care.  We hope to continue to build on the foundations and link those in our care with social care providers back in their community. Fiona Linehan, Lead Nurse

The Outcome

A total of 68 people have engaged in the social prescription programme so far, with 29 men, 38 women, and 1 person who preferred not to say:

Mental health was the most common reason for referral (81%).

The next most common reason was low self-esteem/confidence (15%), personal development (3.8%) and respiratory (3.8%). Other reasons include: work- productivity-leisure-balance,

weight reduction, physical inactivity, motivation for learning, social isolation, PTSD and substance misuse.

To date there are 31 types of services to choose from at Hydebank as part of the social prescribing programme and a total of 79 social prescriptions referrals have been made to these services.

Relaxation was the most popular choice with 44% of patients choosing it; followed by Sleep Better (37%) and Anxiety Management (6%).

The programme has been well received by the patients with a 94% uptake.

Kieran Lynch, Criminal Justice Programme Manager PHE, said, I am happy to support the adoption of social prescribing in prisons and beyond the gate. I am also pleased to see the levels at which Hydebank is going to fully explore and maximise the impacts of social prescribing. With wider health issues, we see wider public health responsibilities and that is why we are supporting the work in NI.

Case Study A

A 60-year-old female was referred by the Mental Health Nurse for physical inactivity, mental health and low self esteem/confidence. Upon the initial consultation the patient scored 14.75 on her SWEMWBS score and mentioned that she has trouble sleeping, and from this, has experienced anxiety and depression. The patient was referred to the Sleep Better/Relaxation course and said she would give it a go but never believed she would benefit from it. In the first session the patient fell asleep during the relaxation and was surprised by how the session worked. She returned each week for the course and found that from partaking in this her sleep improved and she was able to sleep longer in the evenings.

In her mid course SWEMWBS consultation her score improved to 21.54 and by the end of the course it has remained at a higher score of 20.73 – an increase of 5.98. The female patient after the Sleep Better course asked for the content from the class so that she could continue this in her own time to continue to help with her sleep. She also went on to do yoga and started the gym. There were 9 consultations in total with the nurse and course sessions.

Case Study B

A 58 year old female was referred by the mental health nurse for mental health reasons. The patient had been on medication to help with her sleep and was referred to the Sleep Better/Relaxation course. In her initial consultation her SWEMWBS score was a low 7 which would indicate low mental health and well-being. The patient was willing to engage and enjoyed the various sessions from April-August. She especially enjoyed the context around imagining the clouds.

Within the sessions she said what she enjoyed most was the peace and calm and this was what she wanted to get back to. The patient also did not have a good bed which added to the sleeping situation and so this was also improved by the staff by getting the woman a new bed. Mid point in the course the patient’s SWEMWBS score had increased to 19.25 and remained at this by the end of the course – this is a significant increase of 12.25. There were 12 successful consultations in total with the nurse and course sessions.

“Bloody Brilliant, It was absolutely bloody brilliant. I will definitely be back next week. I was asleep within 5 minutes. Anonymous Patient, Hydebank Wood College, following her first Sleep Better Session

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Jennifer and Leeann

Someone’s health and wellbeing can be affected by where they live, what they do for a living, their income or their early childhood background experiences. This in turn leads to some stark, and often avoidable health differences.

We founded Elemental to play an active part in halting health inequalities through the social prescribing movement. Our technology helps communities to be better connected, build resilience and bring real precision to the measurement of the impact of community investment.

We work with organisations that want to continue to invest in their communities but want to be much better at measuring impact and outcomes.

We believe this is a powerful route out of health inequality.

CEO & Co-Founder, Jennifer Neff
COO & Co-Founder, Leeann Monk-Ozgul

Jennifer and Leeann

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