Advice on Prescription - Ways to Wellbeing

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Citizens Advice: Ways to Wellbeing Liverpool

 

A service for every Liverpool GP team.

 

Citizens Advice: Ways to Wellbeing Liverpool is the door through which Liverpool GPs (and authorised partners) access non-medical support for their patients.

The service is made up of two linked but distinct parts:

  1. The Advice on Prescription Programme (APP) which provides practical (anti-poverty) support to vulnerable patients, e.g. benefits, debt, housing.

  2. The Wellbeing Link Worker Service which is the pathway to health enhancing activities and community services (and includes developing pathways to work (paid or unpaid) through confidence building, training, volunteering and employment opportunities.

 

The service is funded by Liverpool CCG and the Dept. of Health (HWF) and its current form is experimental and designed to help establish what the most appropriate wellbeing or social prescribing service for Liverpool should and could look like.

 

How does it work?

The practical, anti-poverty offer focuses on the lowest income households and works to reduce debt and maximise income, and the wellbeing offer connects people with community services that support improvements in physical and mental health. 

 

GP teams and trusted partners refer people who they think will benefit from accessing these services, for example patients who are living with depression, anxiety, loneliness, or people who would like to take up some community activities but don’t know how to access them.

 

A team of support workers take referrals and make contact with patient within two working days.  An initial assessment is made to establish need.  If there is a requirement for practical support, an appointment will be made to see an adviser in a health centre most convenient to them, if there no requirement for practical support the referred person will begin working with the Link Worker to design and develop a  personalised wellbeing ‘action plan’.

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This is not a signposting service; all referred patients are provided with individualised and ongoing advice and support to enable them to access meaningful practical support and access to the community services identified in their action plan.

 

Service Link Workers connect with referred patients to co-produce a person-centred wellbeing or ‘action plan’ that is shaped by the strengths and hopes of the individual.

 

The plan is a working document that reflects what matters to the person, it looks to personal and family assets and strengths as well as the wider community offer – it is built around the activities and community services that support better physical and mental health.   The process of developing the wellbeing plan involves the Link 

Worker and the referred patient using the Live Well Directory and the growing bank of knowledge that this service now has about wellbeing services in Liverpool.  
The Link Worker will then connect the referred patient with community groups and services that provide practical and emotional support.  And where appropriate, Link Workers accompany patients to the venue and provide an introduction and hand holding service.

 

A personalised and co-produced Wellbeing Action Plan.

Referrals

  • Quick and easy– all we need is name, date of birth, postcode, consent to contact and contact number. 

  • The referrer indicated which of the APP services are required – practical- wellbeing or both and our team of support workers contact the patient and based on initial assessment of priority need, arrange an appointment in an appropriate health or community setting.

 

This service acts as the door through which GP teams can access all non-medical support services.  A referral to the team will ensure that patients have access to the rich and diverse public and voluntary sector offer in Liverpool, this service reaches into the most distressed and disadvantaged households and provides appropriate and timely support.

 

Patients referred to this service engage in different ways, according to their wishes, some have a clear idea of what they would like to do are keen to design and develop their wellbeing plans, others prefer to discuss the idea with a view to taking up the option of developing a plan at a later date, and some will not engage after discussing the services available to them, are not interested in going any further.

What we have learned so far

  • Most people who are referred feel isolated and fed up and just don’t know how to connect with their communities

  • Majority of referred patients don’t have a clear idea of what activities they want to access, more interested in any activity that gets them out of the house.

  • Evidence to date suggests that men are more likely to request a specific activity, history, football, photography, gardening etc. but once there state that the company that keeps that going.  

  • Women more likely to ask what services are available and then choose what they want to do – but again it’s the experience and the company – the being with other people that keeps them there

  • Clear preference for local or city centre services, reluctance to go to areas of the city that are unfamiliar or involve more than one bus

  • Biggest anxiety is going to first service – feeling overwhelmed at the idea of walking into an unknown building to take up activities with stranger

  • The majority of patients referred for wellbeing services have practical concerns linked to benefits, bills or housing 

  • People are less likely to engage in wellbeing services if they require support with a benefits appeal, urgent debts or eviction notices.

Working in partnership

 

We are working closely with 3 partner agencies:

  • Healthwatch Liverpool

  • The Women's Organisation and

  • Liverpool Charity and Voluntary Services  (LCVS)

  • Macmillan Cancer Care

 

We have a rich community offer in this city and we are currently working with Healthwatch Liverpool to develop a dedicated Ways to Wellbeing website and directory, a site that brings together all known wellbeing services’ information and how to access them. It will also enable the creation of individualised wellbeing action plans for those who do not need the support of a personalised Link Worker. 

 

The referral for AoP provides GP teams with the option of referring patients for wellbeing and/or practical support.  Service data to date suggests that where a referral is made for either, the patient is best service by being provided with both , because the majority of patients referred for wellbeing services have practical concerns such as rent arrears or council tax debt that have to be addressed prior to the wellbeing action plan development – our experience tells us that people are less likely to engage in wellbeing services if they require support with a benefits appeal, urgent debts or eviction notices.

Income Maximisation for Patients Referred to the Wellbeing Service 

 

The profile of patients referred for wellbeing services is the same as that of those referred for practical services.

They are from low income households, live alone, have multiple health conditions, with the majority experiencing depression and/or anxiety, and so it makes no sense to provide a wellbeing services without an anti-poverty (income maximisation) service to support it.

Over 58% of people referred for wellbeing services have pressing practical concerns that need to be addressed prior to progressing to a wellbeing plan development.

 

Primary Care Networks and planned Link Worker Activity in north Liverpool

 

Disproportionate disadvantage, ill-health 
Unacceptably high child poverty rates
Need for concerted effort to engage those who are furthest away from services and least likely to engage with wellbeing activities in their communities.

Appointments and Contacts

 

Average contact rate: 6–8, but for those who are furthest away from services and so need more support this can be higher.

Interactions can be: phone calls, letters, and voicemail, face to face meetings in health setting, community settings or people’s homes and through these interactions the wellbeing plan is developed and agreed.

People referred for wellbeing services are assessed (within 2 working days).
 

Activities engaged in to date

  • Art classes

  • Digital photography

  • Creative writing

  • Local History

  • Singing/choir

  • Gardening – Dutch Barn

  • Mindful Fishing

  • Bee Keeping

  • Mindfulness

  • Stress Busters

  • Art classes

  • Digital photography

  • Creative writing

  • Local History

  • Singing/choir

  • Gardening – Dutch Barn

  • Mindful Fishing

  • Bee Keeping

  • Mindfulness

  • Stress Busters

  • Pamper Day – wheel meet again

  • Yoga 

  • Chair based yoga

  • Massage

  • Relaxation

  • Pilates

  • Running Groups

  • Bike Riding

  • Table Tennis

  • Walking Group

  • Pamper Day – wheel meet again

  • Yoga 

  • Chair based yoga

  • Massage

  • Relaxation

  • Pilates

  • Running Groups

  • Bike Riding

  • Table Tennis

  • Walking Group

  • Pamper Day – wheel meet again

  • Yoga 

  • Chair based yoga

  • Massage

  • Relaxation

  • Pilates

  • Running Groups

  • Bike Riding

  • Table Tennis

  • Walking Group

This list grows weekly as more services develop (& Wellbeing Directory)

  • Art classes

  • Digital photography

  • Creative writing

  • Local History

  • Singing/choir

  • Gardening – Dutch Barn

  • Mindful Fishing

  • Bee Keeping

  • Mindfulness

  • Stress Busters

  • Pamper Day – wheel meet again

  • Yoga 

  • Chair based yoga

  • Massage

  • Relaxation

  • Pilates

  • Running Groups

  • Bike Riding

  • Table Tennis

  • Walking Group

  • Football at the Brink

  • Walking football

  • Brisk Walking Groups

  • Mums’ Pram Runs

  • Reading Groups

  • Healthy Cooking Courses

  • Active Bingo

  • Community Cooking Children’s Play Groups

  • Volunteering with horses

  • Volunteering with homelessness service

  • Volunteering in hospitals

  • Volunteering in advice agency

  • Confidence for the workplace

  • Budgeting and financial confidence

  • Confidence building for Socialising

  • Preparing your household for work

  • English Conversation for the Newly Settled

  • Social Event with Support Group

  • Hoarders for Hoarders (support group)

Trusted Partners

(with authorised inter-referral protocols and direct routes into service)

  • Talk Liverpool 

  • Healthwatch Liverpool 

  • Mary Seacole House 

  • Domestic Abuse Services (for Specialist Debt only)  

  • PSS Wellbeing Centres 

  • Barnardo’s Young Carers 

  • YPAS

  • Liverpool Sunflowers 

  • WHISC 

  • Palliative Care 

  • Social Inclusion Team 

  • The Stroke Association 

  • The Primary Care Mental Health Liaison Team  

  • Pulmonary Rehabilitation 

  • Sahir House

  • Macmillan

  • Age Concern Liverpool

  • Adult Learning 

  • Healthy Homes 

  • Livewire Health Trainers 

  • Sanctuary Family Support

  • Better off Finance

  • Merseyside Youth Association

© 2020 by Citizens Advice Liverpool

All rights reserved.

Registered charity number: 1169879

Company limited by guarantee
Registered number: 10286899 England

Registered address: 242 Picton Road, Liverpool, L15 4LP

Authorised and Regulated by Financial Conduct Authority:

Citizens Advice Liverpool Limited: FRN-776447

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