We are moving towards more tailored care as seen in the huge focus on social prescribing, prevention, greater integration and use of primary care. Changes include achieving parity of esteem for mental health. Refocusing on the community means more attention on population health using multidisciplinary teams more effectively .
Prevention and social prescribing hope to reduce A&E pressure and hopefully adopt a more strength-based approach, working with the individual, involving them and supporting them to do what matters to them and removing barriers. It also requires a system-wide approach, with the removal of barriers, to increase the control an individual has over their own health and care, moving towards a more personalised approach.
The current emphasis is now much more on how people control and experience their care . This requires greater focus on the person and what matters to them, not just what’s the matter with them. It also requires integration, not only between health and social care but also the independent sector and communities themselves, who need to become more skilled and resilient. Improving population health also requires local District and Borough Councils as well as the pivotal involvement of the local communities themselves, in ways that work for them, for improved prevention and proactive care and increased wellbeing. This requires moving resources nearer to the people.
Of course, people need to know how things work and how to get information to help them help themselves. In addressing the wider determinants of health, even more important to many, than knowing what is available, along with good sign-posting, is enabling meaningful relationships and connections with others and de-medicalising some of the causes for people’s visits to their GP. Here, the role of ‘social prescribing’ through the Link workers can connect with the local community and helpful professions such as occupational therapists, physiotherapists and others in the wider community teams, adopting a ‘whole person approach’. This is an approach where people are not just seen as ‘conditions’ or separated out from other parts of their lives that matter to them. Everything is interrelated, so focusing on both physical and mental wellbeing allowing individuals to achieve their potential holistically is the way forwards.
To make this effective requires deeper joining up of the community facilitating and helping communities to work together in new ways to plug gaps of needs and build further capacity where needed. It means working outside their normal parameters in partnership with other local groups, charitable organisations, business and statutory services. For example working together with leisure partners, arts centres, churches and local shops and businesses can support individual’s fitness, nutrition and psychological needs. This joining up is what SMART Cranleigh is trying to support (www.smartcranleigh.org). All of this requires a change of thinking and culture change where people feel more involved and then empowered to make changes.
New ways of thinking and behaving will be needed to achieve better health and wellbeing in today’s changing world. The new PCN’s (Primary Care Networks of GPs in population clusters) who will now be more multidisciplinary in their focus, will also play an important role in prevention and reablement. This will include the social prescribing initiatives where new Link workers (also known as wellbeing connectors and other similar terms) can support people to make changes earlier before a crisis or problem become acute and help people to find ways of taking more control and getting the help they need from a wider pool of resources.
Within the new Primary Care Networks, the hope is that the Allied Professions role can be more clearly understood and managed in ways where they make more of an impact through better access and a good referral system. Generally GP’s need more education to understand better these roles and what they can achieve for their patients, and how they adopt a wider whole person perspective to bring about sustainable change in people’s lives.