Tag: social prescribing

Bridging the gap between healthcare and wellbeing #4

A final (for now…) post on the interesting shifts of culture and practice that might get state-supported health care and the church’s role at the heart of local communities finding common cause and networking together.

It could be a (quiet, slow) revolution in healthcare and it would not be the first time that church initiatives have altered the national landscape.

  1. The probation service was started by a pair of Anglican missionaries in the early twentieth century, and eventually nationalised.
  2. Educating the working classes was a job pioneered by the Christian churches, with both Catholic and Protestant examples. In the UK, Sunday Schools were teaching literacy and numeracy (and Bible literacy) to a quarter of the eligible British population of children by 1831. 1. (Schools until then were largely private, fee-paying and for the upper class and middle class boys.) In 1870 came the Education Act which made state education compulsory and a state responsibility.
  3. The hospice movement which had earlier (and largely Christian) precedents but in its modern form was established by the devout Christian Dame Cicely Saunders. So far the UK’s 220 or so hospices have escaped being swallowed by the NHS but at Dame Cicely’s death in 2005 were caring for 60,000 people in hospices and 120,000 people in their homes in the UK 2. Eight thousand other hospices followed her model around the world; part of the landscape for the dying. (Interestingly, Dame Cicely was a passionate opponent of assisted dying.)
  4. Possibly, hospitals themselves, invented early in the first millennium by St Basil and his fellow Cappadocian Fathers.

Bridging the gap between healthcare and wellbeing #3

Photo by Jon Tyson on Unsplash

So I have to request you be patient for a little longer. Here’s a third take on the changes intended for the National Health Service and how these changes take it into the arms of the Christian church, and how they can help re-establish the church in its centuries-old role as centre-piece of the good in a local community.

A newspaper report in April 25 said this:

The NHS is attempting to ease the pressure on GPs and A&E by sending a new type of health worker door to door in deprived areas to help detect illnesses before people need urgent care.

Community health and wellbeing workers (CHWW) are already deployed in 12 areas of England, with 13 others to follow, in an attempt to improve poor and vulnerable people’s access to care.

Each worker is responsible for 120-150 households, usually on a council estate, which they visit once a month to help residents with money, isolation and housing problems, as well as their health.

Wes Streeting, the heath secretary, is examining the scheme as he pulls together ideas to help “fix” the NHS that may be included in the forthcoming 10-year health plan. 3 The article points out these CHWWs ‘are not clinically trained staff, like doctors, nurses and health visitors. They are mostly recruited from the communities they work in and trained up for the role.’

It quotes the program managed of the National Association of Primary Care as follows:

‘CHWWs are supporting residents to access earlier and more appropriate forms of care, often in community settings.

‘They’re also helping to address wider determinants of health – like housing, finances and loneliness – which are frequently the root cause of escalating health issues that end up in A&E.

‘Their job is to build relationships with the people in their households and with health professionals and NHS services locally.’

Nothing in the article mentions the church. But what a nice job for someone as a CHWW, with formal or informal links to faith communities.

Bridging the gap between healthcare and wellbeing #2

Photo by Jon Tyson on Unsplash

So last week we saw that the UK National Health Service, groping its way to being a Neighbourhood Health Service, is seeing the value of directing people from GP surgeries to community groups. Faith groups–and especially in the UK, Christian churches–are the main source of community groups, and they are everywhere.

In a report about all this, the Theos thinktank notes that some GP practices employ social prescribing link workers (SPLWs, because the world needs more acronyms) to make and maintain these connections. So far so good. But the people at Theos make these observations:

  1. Where there’s a high turnover of SPLWs, many of the links are lost.
  2. When SPLWs merely ‘signpost’ people to things a lot of the potency of social prescribing is lost. (This is true generally with the dread word ‘signposting’. People are often refused help by one agency or another and ‘signposted’ elsewhere. This is fine for the people who are turning people away, but not so good for the people who are being turned away). It’s much better when SPLWs get to know groups personally and also take people along to them. The personal relationships matter much more than a listing of providers.

As the report said:

..We found a number of challenges … There are communication challenges because faith and health communities use different language to talk about very similar things. It is challenging for faith groups to connect and maintain relationships with the ever-changing social prescribing system. Similarly, link workers and local health practicioners don’t kow where to go to connect with local faith groups. Furthermore, there are administrative challenges that slow processes down and a lack of funding to keep activities running. (p15)

Further, ‘one explanation for poor integration between faith groups and healthcare workers … is stretched capacity in the NHS’ (p61).

But social prescribing is a ‘thing’ and the NHS has a long term plan for every person in England to access social prescribing through their GP eventually. 4

3. While there are relatively many hospital chaplains, there are relatively few ‘GP chaplains’ and this is a missed opportunity. N0t only so, but a qualification in social prescribing takes about 5 months’ study 5. No doubt lots of people have thought of this, but a GP chaplain who was also a trained social prescriber could make themselves very useful; if they were funded by a collaboration of churches, they would be less dependent on the vicissitudes of government provision.

How to transform every community in the West

Nothing too ambitious….

Photo by Jon Tyson on Unsplash
  1. Start with a worshipping community of Christians
  2. It has to use some energy maintaining itself but
  3. It has spare energy to use outside itself so
  4. Do some theology. Christians are heralds of a new world where God and people are together. We can’t make that new world, but we can be a sign of it, an instrument of it. A portent of it, if you like.
  5. Do some Bible study. Around Ash Wednesday (not so far from when I’m writing this) the great passage in Isaiah 58 defines what ‘fasting’ looks like:

“Is not this the kind of fasting I have chosen:
to loose the chains of injustice
    and untie the cords of the yoke,
to set the oppressed free
    and break every yoke?
7 Is it not to share your food with the hungry
    and to provide the poor wanderer with shelter—
when you see the naked, to clothe them,
    and not to turn away from your own flesh and blood?
8 Then your light will break forth like the dawn,
    and your healing will quickly appear;
then your righteousness[a] will go before you,
    and the glory of the Lord will be your rear guard.
9 Then you will call, and the Lord will answer;
    you will cry for help, and he will say: Here am I.

(Isaiah 58:6-9

6. Understand the times. We are not, in the West, surrounded by masses of starving people. But think of all the lonely people.

7. Think of one of the fruits of the covid pandemic. In the UK, local authorities started trusting churches to do community things decently and well. It has always been happening to an extent (it isn’t new) but covid was a kind of crash course for the nation.

8. Think of the need in our day for social prescribing. How many doctor’s surgeries are plagued by the lonely? How many ills (mental ill-health but much else also) can respond to the balm of community? In how many ways can community complement all that the state attempts to provide (housing, cash, healthcare)? Why can’t GP surgeries prescribe community in the same breath as they’d like to prescribe exercise and diet? Why are their options limited to applying chemicals or knives to human bodies?

9 Churches have premises, a certain facility with tea-pots, and a tolerance for the misfitting people whom every congregation anyway hosts.

10. Community heals. Humans are a herding species. Churches have the plant, the location, the resources, the opportunity and — best of all — the moment. We can built the connections. Every community in the West. Think of it.