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A digital social prescription tool that allows GPs to prescribe information, services and online support, has been integrated into the clinical system EMIS Web.

Initially live in two GP practices, the technology will be rolled out across practices in North East London as part of our unique partnership with tech company HealthUnlocked.

By embedding this new type of technology directly into the GP system, doctors will be able to quickly and easily deliver a digital social prescription to the patient as part of their standard consultation or appointment. The tool directs and signposts patients to local services, charities and voluntary sector support, and relevant HealthUnlocked online support communities. 

Dr Matt Jameson Evans, Chief Medical Officer of HealthUnlocked said: “Digital social prescriptions have the potential to completely change the management of hundreds of conditions. By using technology and opening up support and services to patients, we can give people the tools to a better quality of life, reduce reliance on medications and radically rethink how we manage chronic health conditions. The most significant benefit is the potential to reduce demand on Emergency Departments (ED) and GPs in the NHS.”

Dr Amit Sharma, a GP at Tulasi Medical Centre, the first practice to go live with the tool, said: We know that access to more information and support can change how you manage your health and your health outcomes. The concept of social prescription is not a new one, but having the ability to provide it quickly and easily during a consultation, and know the information is reliable, suitable and helpful is new. This will make a difference to a lot of our patients, whether they have cancer, diabetes, or would benefit from losing weight.

Shaun O’Hanlon, Chief Medical Officer at EMIS Health said: “We’re delighted to be able to integrate this new tool into EMIS Web, the most widely used primary care clinical system for GPs in the UK.  We know that our users appreciate seamless integration with technology from our partners,  ensuring quick and easy access to the technology, is what GPs want and we hope this will enable them to offer access to social support more easily. We’re pleased to support this roll out.”

John Craig, Chief Executive of Care City said:  “The process and use of social prescriptions has for far too long been too difficult. By putting social prescribing at the GPs fingertips – within the patient record - and enabling it to be shared with patients at the touch of a button, we have made the process quicker and much more useable. By doing this, together with HealthUnlocked and EMIS Web, we will also be able to collect data about the use of social prescribing and its effectiveness allowing us to collect a reliable evidence base.

For GPs not using EMIS Web, patients can be directed to the HealthUnlocked app (IOS) found in the NHS App store, having been one of the first apps to be approved by NHS Digital.

In August 2016, Care City was awarded a grant by Health Education England (HEE) to deliver an educational programme designed to empower the local health and social care workforce to make necessary efficiency savings, integrate and innovate.

Care City had identified demographic pressures, the changing burden of disease, rising patient and public expectations and reduced public funding as drivers behind these needs. Making these improvements is dependent upon a workforce that is skilled in Quality Improvement (QI), a systematic approach that uses specific techniques to make care safe, effective, person-centred, timely, efficient and equitable.

Over the last year, the Care City QI Programme developed and delivered:

  • The ‘Foundations of QI’ course, a one-day basic course in QI, with the aim of spreading QI knowledge and awareness to a high number of people across the system.
    A coaching programme to upskill a smaller group of QI champions to cascade learning to other frontline workers within and outside of their organisation, initiate and sustain quality improvement within their own organisations.
  • Access to IHI Open School licenses to allow those who could not partake in classroom learning the opportunity to train in QI through online distance learning.
  • four quality improvement collaboratives including falls reduction and improving AF detection and management, spurring on QI activity across the system and demonstrating what could be achieved.

Earlier this year Skills for Care were appointed to conduct an independent evaluation of the QI programme, with the aim of answering the following key question: How does the Care City Quality Improvement programme impact on staff: perceptions of their role in improving quality, the extent to which they feel empowered to engage in improvement activity, behaviour in their day-to-day roles and any improvement activity they engage in?

Evaluation Findings

  • The delivery of the QI programme has been a success and has added value to the local system. 
  • The programme is unique in its design, context and links to other initiatives, leading to locally specific learning and connections that are unlikely to have taken place without the experience of the programme.
  • The ‘Foundations of QI’ course has been delivered to over three hundred and fifty participants, and the coaching programme to fifteen.
  • The ‘Foundations of QI’ course was rated ‘excellent’ or ‘good’ by 97% of respondents.
  • Its facilitators were rated ‘excellent’ or ‘good’ by 100% of respondents
  • All the respondents from the coaching programme also rated every aspect of the course as ‘excellent’ or ‘good’.
  • Beneficiaries interviewed said that they found the learning for the course easy to fit around their job, enjoyed the course and found the pace good.
  • Beneficiaries interviewed also told of how completing the course had helped increase their confidence, refresh their skills and remind them of the importance of embedding QI in everyday activity.
  • Most coaching respondents said that they had both improved quality at their workplace and rolled out learning to other colleagues – on average four further people had been trained per coach.
  • Stakeholders agreed that Care City was the right organisation to deliver the QI programme. They recognised it has a local, unique and neutral position, cutting across research, education and innovation, approaching the system as a whole and having important relationships with other players.

Skills for Care commented “The Care City QI Programme appears to have been a resounding success. At reasonable value for money, an excellent team of staff have been recruited and made a positive impression with local stakeholders; and a curriculum has been developed which is widely considered high quality and has been adapted by two other major providers for their own use.”

Dean Rigg, Programme Manager, Care City commented “Evidence suggests that organisations that adopt QI practices are more likely to improve outcomes and experiences for people who use their services and achieve ‘Outstanding’ CQC ratings. We are delighted that Skills for Care has given our QI Programme the seal of approval and that we have been able to support local organisations to develop a culture of improvement where all staff feel supported to speed up and influence change.

“Simple to use and complete, interesting and thought provoking learning.” “Easy to understand and modules can be done anywhere, even on your phone while on the bus or train.” – E-learning participant.

“It reinforced good practice that I knew about, it has corrected some bad habits, it’s provided an aide-memoire in terms of some of the discipline around QI… I think it has been helpful in reminding me around the disciplines required.” - Participant on the ‘Foundations of QI’ course (NHS employee)

'Sense of place' is one of our Healthy New Town priority themes.  We know that so-called 'place attachment' is good for people's wellbeing. Place attachment is very much about having positive experiences of where you live, often to do with nature or history, and also to do with contact with people (and Connectivity is, of course, one of our other HNT themes).

As well as place attachment and social networks, we know that access to nature is great for people's health. Most of the evidence is about 'green space' and its health benefits (parks, gardens, street trees etc). More recent research has looked at 'blue space' and found that this can be even better for our health. So far, this is mainly about the sea and oceans. At Barking Riverside, we want to find out more about the potential health benefits of access to a river as well. For example, residents have told us that they want more peaceful places to help them relax and be calm. We think that an attractive and accessible riverside could be important for local people's mental health.

Developing a sense of place can be difficult in a new town, and when new residents are coming together for the first time.  However, Barking Riverside does have a history and also some great natural assets. This weekend, ThamesFest, in conjunction with Totally Thames and Silk Road, celebrates London's great river's past and present - as a working waterway as well as a place of enjoyment.

Look out for us and our partners from Sustrans, Living Streets and University College London at the Rivergate Centre on Saturday.  We are collaborating on a range of activities to encourage people to be more active in their everyday lives, find out more about the place they live - and enjoy the river.  We are calling on everyone to help us design a community mural, which will complement the Nature Garden, which shows how you imagine Barking Riverside in the future.

Author: Catherine Max, IKEN Associates. To read more from Catherine, why not visit her Sense of Place themed blog and the importance of access to blue space to health and wellbeing.