Resources and Events – Case Studies

South Dublin County Partnership: August 2020

About The Project

South Dublin County Partnership (SDCP) is a local development company in South Dublin County, Ireland. The community and voluntary sector organisation develops and delivers projects to tackle poverty and social exclusion in the area through working together with local groups and partner organisations to address the issues that matter most. Its aim is to make South Dublin County a place where people of all backgrounds and abilities can realise their full potential within thriving communities.


In 2018 as part of their Health and Wellbeing Strategy, SDCP launched a partnership with Elemental Software to develop a pilot social prescribing project, funded by Healthy Ireland and the Social Inclusion and Activation Programme, which enabled GPs within two neighbourhoods to make instant referrals into its services.

The Challenge

SDCP’s social prescribing project, Get Well…Connected, was developed for people over 18 years of age in South Dublin who found they needed additional support for wider health and well-being needs identified by their GP.  It is specifically designed for people who may feel lonely, socially isolated, anxious, depressed or in need of other forms of social support.

A number of objectives were set around the challenge to:

  •  Improve connections between the health and community sectors
  •  Reduce pressure on clinical services
  •  Improve wellbeing

The Solution

Using Elemental’s social prescribing platform , referrals are made by two GP surgeries through to SDCP’s social prescribing coordinator, who’s role it is to work with anyone referred into the service to assess their needs and work together to look at the activities and programmes that could help to support their wellbeing. This could range from taking part in monthly walking groups, park runs and social clubs, to gardening clubs, counselling and holistic therapies.

This could range from taking part in monthly walking groups, park runs and social clubs, to gardening clubs, counselling and holistic therapies. Elemental’s platform also enabled SDCP to record and monitor all interventions with social prescribing clients, with an important feature being the mapping of services and resources including a geographical map that allowed them to identify how accessible services are to individual clients.

The Outcome

Overall, between January and October 2019 there were 108 referrals from 11 doctors at Tallaght Hospital and one nurse across the two GP practices. 58% of referrals were for people aged 55 and over. There were significant numbers of younger people referred to the project – 19 were under 25 years and 34 were under 45 years old.

Social prescribing appears to have had a significant positive impact on well-being of participants. Participants reported a significant reduction in causes of concern in their lives(well-being measure). Community involvement and awareness of community services has increased. The role of the social prescribing coordinator was an essential link, working directly with patients, healthcare staff and community workers.

  • Reasons for referrals included:
  • Isolation and loneliness (38%)
  • Anxiety and depression (29%)
  • Employment (10%)
  • The average Well Being measure improved over the monitoring period by 39% 

They particularly valued learning about the GPs having another pathway and another referral option when they had done everything they could to support clinical needs and the wealth of community resources available which they had been unaware of. GPs also reported that they found Elemental’s platform easy to use, enabling them to make referrals quickly.

They highlighted the fact that they are able to access real-time live patient information such as patient engagement, attendance rates and pre and post baseline metrics for the patients they have referred. The added value of Elemental’s platform in facilitating remote working during the pandemic has been highlighted as a vital asset.

“I’m on the software all the time. It’s really easy to use, and, as a former nurse, I find the measuring tools invaluable. I ask people if they have concerns at the beginning when they are referred to me and at the end so that I can measure myself on whether I’m meeting their concerns and what services I can refer them into to meet their needs. Deirdre Ruane Social Prescribing Coordinator, South Dublin Count Partnership

Patient Case Study

One person who took part in virtual activities during the lockdown, as restrictions got underway, described being contacted by Deirdre as “a lifeline during this cocooning time”. She had been referred by her GP surgery in March by the practice nurse, and quickly got involved in the Zoom meetings. She said: “It was great to have contact every week.

I really enjoyed the chat and the meditations we did together gave me great peace and calm. I learnt how to do Skype and to perfect using Zoom on my tablet and phone. Overall the contact gave me assurance that I was not alone during this long, protracted shutdown and that If I needed help, I could get it.”

Another participant commented: “The weekly visit on Zoom was a god-send at the time, and the wellness talks were of great benefit, I looked forward to them every week. The virtual walk each week was excellent and allowed us to express ourselves walking in different counties, from Tramore Waterford to Cork to Galway. This really was a great experience and very important to the whole group.”

Covid 19

”During the COVID lockdown, it provided a lifeline to being able to continue offering digital support to patients.“The whole landscape changed overnight in terms of how we work”, Dierdre explains. “The data we have on referrals through Elemental was key to our response, and if we have the expected second wave, this data will make a real Difference.”

Deirdre got a group of around 10 people together that were happy to learn how to use Zoom, and she arranged a weekly ‘virtual walk’ to help them keep the connection they’d built up through the monthly walks. Everyone took it in turns to pick a different location each week to share with the group their memories and experiences with that place, as well as keeping a log of all the steps they’d all taken during the week.

She also led meditations and mindfulness exercises. “It really opened up a new way to connect”, Dierdre said. “I had the opportunity to hold this group in a space where they were connecting with each other and through the Elemental platform, I could also report back to the practice managers at the GP surgeries about how they were doing.

“The group is becoming much more independent now and able to start meeting up to do socially distanced walks. I would never have got all the insight into how they were doing in the more traditional way of working before the lockdown. The virtual group created a really safe space for them to talk to me about their concerns and I think it has changed the way we deliver social prescribing for the future.”

“The data we have on referrals through Elemental was key to our response, and if we have the expected second wave, this data will make a real Difference.”

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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

A message from our founders