15 March 2021
As we approach Social Prescribing Day on Thursday 18 March, Mike Proctor reflects on what made him a proponent of this approach in wellbeing and healthcare. Mike is Conclusio’s non-executive chair and recent NHS Trust chief executive. He is also a non-executive director with an NHS Trust in the east of England. Mike’s NHS experience spans 45 years, which he commenced as a nurse, and embraces both clinical and non-clinical roles.
In 2012 I had spent 35 years in secondary care. 20 years as a clinical nurse and 15 as an executive director. Secondary care was all I really knew, and it felt to me as though secondary care was at the centre of all healthcare, orbited by the rest of the care system. My world view began to change through ‘Transforming Community Services’1 where my organisation ‘took over’ the management and delivery of community services. This exposed me to a different health and care workforce, a new culture and a more diverse and direct understand of patient needs and of health rather than illness.
Looking back now I can identify three seminal moments around that time which have influenced me ever since. The first was when I was invited to speak at a conference in Harrogate organised by the Independent Care Group – a membership organisation for the independent care sector in Yorkshire. Instead of just turning up to do my 40 minute slot, I decided to attend for the whole day and listen. I was completely bowled over by the people I met, as devoted to their clients and their needs as the best of the nurses and doctors I had ever worked with. I am now ashamed that I was so surprised.
The second was when I was on an interview panel for the head of adult social care at City of York Council. One of the candidates was inspirational and spoke of the work he had done on the development of personal budgets, he gave some wonderful, heart-warming and resource saving case studies. We later worked together and he became a friend, advisor and challenger.
The third was attending a presentation on social prescribing at York Centre for Voluntary Services. I didn’t know anything about social prescribing but the presenter spoke passionately about the link between loneliness and social isolation and physical and mental health, relating some wonderful stories about how link workers had been able to give people time and a focus on what mattered to them in order to signpost them to local resources delivering great outcomes. It switched a light on for me and reminded me that as a nurse and a chief executive that I should also be focussed on holistic approaches to care and maintaining health rather than viewing patients through their physiological problems and illness. I had, in short, become a convert.
The challenge for social prescribing now is creating more converts, turning dyed-in-the-wool public sector managers and health and social care professionals into agents of change who can contribute to achieving consensus on developing and consolidate it within a universal wellbeing and wellness schematic in integrated care.
Wellbeing, in particular, has always been seen as a downstream activity, a nice-to-have supplement to therapies and interventions. As health and care services ask people to engage more with their own needs, as we design services that combat exacerbation of long term conditions and the onset of avoidable illness, we need to move this valuable intervention upstream. Rather than at then end of an integrated care pathway, it needs to be at the start and continue to support people throughout their entire care journey and experience.
As health and care system leaders, it is our responsibility to listen and learn from those who have been pushing forward the social prescribing agenda. For our part, we can be instrumental in helping to reach consensus on approach, defining an outcomes framework, determining the metric for evaluating the impacts of social prescribing and setting the terms on how it is commissioned within integrated care systems.
References
- Transforming Community Services