Tom Watkins, East of England Regional Lead

Thriving Communities Programme, National Academy for Social Prescribing – Hosted By Communities 1st

Text from presentation given on 13th May 2022 at A Space to Be… Final Celebration Event

The principles of what has allowed “A Space To Be” to be a success are elements of life which are very dear to me. I’m passionate about enabling people to discover their own creativity, and in doing so build resilience, define purpose and form communities. I believe in the power of Art because we are social creatures that have an inbuilt need to express and share. We all have stories and art is manifested when we choose to share that story. It can take any form. When we appreciate someone else’s art, we make a connection to their story. Each of us is also connected to our own unique culture; an ugly/beautiful heritage, an exciting and messy history comprised of the stories and circumstances of those that made us who we are. This heritage informs the way we respond to circumstances in the now, so by exploring it through creative expression we can gain more clarity on who we are, how we find our place in society and… the better we get at creating we discover more ways of taking control of writing our own stories, rather than letting others dictate it for us.

We’re complex beings, never more so than when we are young, trying to discover who we are and what we can do, fighting against the clock before the harsh realities of adulthood come along and gut punch our dreams away. I don’t think being young ever gets any easier and the pressures put on each new incredible generation of young people are unprecedented. I’m not sure they get enough credit for how well they’re doing despite the mess the so called “grownups” create at times.

I said that we are complex beings, that being the case, these Beings need a place or even a SPACE to BE. A space to be where they can BE welcomed, BE safe, BE authentic without being judged. To be in a space where they can connect with others and at times more importantly with themselves. It’s said that you don’t need to be alone to feel lonely, not all those who are solitary are lonely and you can have enormous groups of friends and yet feel completely isolated. The element that is missing is understanding, when we are understood, truly, genuinely, compassionately understood it is much easier to be part of a community. It’s easier to feel safe when you expose your vulnerabilities. That’s where the magic happens. Looking around this space today, hearing how this project has worked it’s clear to see that a safe place was created, a place where those who participated were able to unburden themselves of toxic thoughts and behaviours that hold them back. It’s truly remarkable and so important that spaces like this exist for young people, outside their schools, outside of a medical setting. A place where they can just BE, not treated as a list of symptoms or a problem element in a classroom or anything else. Just be who they are.

Social prescribing is described as a means of enabling health and care professionals to refer people to a range of non-clinical services to support their wellbeing. Social prescribing connects people practical and emotional support based in their community through a knowledgeable professional – Link worker often supported by local infrastructure agencies. For me, it’s more than that.

The approach of social prescribing is about all of the things we’ve just been talking about. It sets out to improve quality of life by way of this professional link worker unburdening you of the barriers that may hold you back, taking the time to understand what is important to you and enabling you to find a social intervention or activity which allows you to become part of a system of support you have chosen for yourself. It sits apart from the traditional bio-medical model and at its most basic a social prescription offers the kind of help that doesn’t come out of a pill bottle or take place on an operating table.

Paracetamol has the same chemical formula wherever it’s found around the world. An appendectomy (barring complications) is a fairly routine procedure that happens day in and day out in hospitals from Stevenage to Shanghai. Every single social prescription is unique to the person that receives it. It’s personal, it’s about you having more control over your own wellbeing.

It asks “what matters TO you” rather than “what’s the matter WITH you”.

It works too! Countless studies are proving that those who have a social prescription get better and FEEL better faster than those treated with medicine alone. OF COURSE THEY DO!

To bore you with some facts figures and technical jargon for a moment 80% of our health and wellbeing is psycho-socio-economically determined! Access to a good doctor accounts for just 20% (if that) sorry doctors, you’re wonderful but it’s not all about you! That 80% is made up of all sorts of other things, where we live, what we eat, how much exercise we get, our finances, access to good education, skills and work, transportation, our relationships with family, friends, neighbours and wider communities… much more!

Social prescribing tackles that stuff. It connects people to their communities in the way they choose. Communities where they can discover understanding friendships, new activities in the natural environment, help to get on top of finance or housing issues, support with training or employment and of course different avenues for creative expression!

When you know that 1 in 5 GP appointments are booked for non-medical reasons it’s easy to see why the government and NHS England decided in 2019 to make a long-term investment in Social Prescribing link work. Since then, the number of link workers operating out of primary care settings has exploded across the country. There are link workers to be found in the vast majority of GP surgeries from Preston to Penzance.

A big shout out to all of my social prescribing link work colleagues local – they are given a number of titles in Hertfordshire including community navigators. Whatever they are called I am speaking from experience when I say they do such incredible work. It was in that profession here in Hertfordshire nearly a decade ago that my journey in Social Prescribing started. Back then no one knew what social prescribing was, there were just 6 of us covering West Hertfordshire. The only such project in the East of England. We had a district to look after, each, and a remit to – “Just see what you can do” fast forward to the present day and we have around 80 link workers across the county and a few hundred in the East of England region. Look wider and they’re part of a national community of 2000 and growing in primary care alone.

We’re very fortunate in Hertfordshire to have a mature and developed model of social prescribing. Hertfordshire are pioneers in this field, we have some forward-thinking strategists making the decisions that count and trying very hard to get social prescribing right. We have a truly incredible voluntary, community faith and social enterprise sector providing support, services and projects, just like this one that put people in the centre of what they do and hold our communities together. The commitment to collaboration between these very different worlds has not come without its challenges but it is tangible, and we are definitely seeing the positive progress that integration brings.

We’ve come a long way in social prescribing development over the last decade, but we’ve got a long way still to go before it achieves it’s potential. We need to also make sure that we don’t lose the magic by losing sight of what makes it effective. Oftentimes these days it’s very easy to make social prescribing too complicated. It should be very simple, very easy and flexible enough to meet people where they are.

For me, there are a few principles that constitute what I would call faithful social prescribing. It starts with a conversation, often a long one. Social prescribers need the time to get to know the people they are working with. They need to be prepared to do a lot of listening. It takes time to gain an understanding.

Sympathy is not enough, you cannot remain at arm’s length from those you support, social prescribers commit to empathy, standing alongside, seeing the person and not the symptoms or a diagnosis. In this sense the intervention, goes beyond simple signposting, you join hands and go on a journey together.

To be a good companion on this journey social prescribers need to prove themselves reliable by being knowledgeable about where help can be found, this only comes from being well connected to the community. With your finger on the pulse of the community the more knowledgeable you become and the more effective the actions you take will be. Knowledge + Action = Trust

Being a social prescriber essentially requires you to be adept at building and maintaining relationships. It’s not about how well you write a report, where you went to school, or how many certificates you have on the wall – it’s about emotional intelligence.

I now run Thriving Communities in the East Region, which is a National Support Programme for voluntary, community, faith and social enterprise groups working alongside existing local infrastructure agencies and Social Prescribing Link Workers. Communities 1st, a local infrastructure organisation, delivers the regional programme in the East of England. We take a bird’s eye view of social prescribing development and champion and support its growth across communities.

The roots of what we now consider social prescribing in the UK can be traced back to The Bromley-By-Bow Centre, which was established in 1984, I think it goes back even further. I think it’s as old as the human species itself. As I said, it’s the most innately human thing to share a story and connect with others. We are a social animal, we collaborate.

I believe that social prescribing collaborations contribute to a culture in society where people feel safer. Safer to be vulnerable, reassured that the community will catch them when they fall. We need to keep building, keep collaborating, what we’re aiming for is nothing short of a well-connected community ecosystem where social prescribing is everyone’s business. This needs real and radical investment.

Yes, the NHS has made the first move, a bold move by making an enormous financial commitment to fund social prescribers, research and resources that develop this way of working. But what good are lots of amazing travel agents without excellent holidays to send people on? We need to invest in the community infrastructure, we need to sustainably fund incredible projects like this one and thousands more like it. We often look to the NHS and local authorities for answers to these questions around funding and YES, commissioning has to evolve, sure. But remember, I said real and radical investment, the NHS can’t do that alone, certainly not at the moment. They’ve made the most substantial financial commitment to date in social

prescribing, but they haven’t bought it and they don’t have the final word. Social Prescribing belongs to the entire community, and it is a system wide approach we need to get us to the next stage. We need to be bold and convince other stakeholders with heavier purses to cross our palms with silver.

Social Prescribing has applications far beyond the primary care setting; I’m really inspired by what I see in the specialised Link Work developing across our region, embedding itself in all corners of the community. Pioneering stuff is happening on our doorstep – Children and Young People’s social prescribing, like that done by our friend Ben Nesham [Link Worker (Young People) – Stort Valley and Villages] who is here today, we’re seeing Perinatal social prescribers looking after parents needs through pregnancy, birth and beyond. Social prescribers who specialise in working with Veterans and refugees. We’re starting to see link work appearing within the Criminal Justice system with a pilot scheme in Stevenage funded and run by the Prisons & Probation service. I’m delighted to also be supporting a brand-new pioneering scheme investigating and evidencing the impact of culture and heritage interventions in Great Yarmouth and Lowestoft funded jointly by Historic England and The Restoration Trust, the first and only one of its kind in the country.

I hope I’ve already shared enough with you by now to convince you that social prescribing has real potential to build a safer and more caring community. I truly believe it has the ability to make it a fairer one and in these cripplingly hard times of squeezed incomes, rising cost of living, deepening deprivation and widening health inequity we’re going to need a proactive, compassionate and personalised approach to reach those in most need with help that is going to empower rather than disenfranchise them.

Reading Time:
14.7 Minutes (Approx.)