scholarly journals Social prescribing in practice: community-centred approaches

2019 ◽  
Vol 30 (7) ◽  
pp. 338-341
Author(s):  
Michelle Howarth ◽  
Liz Burns
Keyword(s):  
General Practice ◽  
Health Conditions ◽  
Unique Contribution ◽  
Physical And Mental Health ◽  
Practice Nurses ◽  
Health And Wellbeing ◽  
Social Prescribing ◽  
Care And Support ◽  
What Matters

More people are living longer with multimorbidities, many of which are handled in general practice. Michelle Howarth and Liz Burns highlight the contribution that general practice nurses can make to providing person-centred approaches to improving health and wellbeing The NHS Long Term Plan recognised the need to understand that ’what matters to someone’ is not the same as ‘what's the matter with someone’. Conversations that focus on what is the matter with someone typically draw out the patient's needs, with assessment and care planning based on classic principles of pathogenesis and accompanying clinical solutions. Conversations that consider what matters to someone draw out a person's individual assets and what is important to them, with personalised care and support planning based on principles of salutogenesis and non-medical solutions, such as social prescribing. This article explores the pivotal role that practice nurses have in maximising their impact on personalised care and population health for all, including for people living with long-term physical and mental health conditions. It highlights the unique contribution that practice nurses can make in strengthening community-centred approaches to health and wellbeing in primary care.

scholarly journals Health of mothers of children with a life-limiting condition: a comparative cohort study

2021 ◽  
pp. archdischild-2020-320655
Author(s):  
Lorna K Fraser ◽  
Fliss EM Murtagh ◽  
Jan Aldridge ◽  
Trevor Sheldon ◽  
Simon Gilbody ◽  
...  
Keyword(s):  
Mental Health ◽  
Cohort Study ◽  
Secondary Care ◽  
Incidence Rates ◽  
Health Conditions ◽  
Clinical Practice Research Datalink ◽  
Physical And Mental Health ◽  
Term Condition ◽  
Limiting Condition

ObjectiveThis study aimed to quantify the incidence rates of common mental and physical health conditions in mothers of children with a life-limiting condition.MethodsComparative national longitudinal cohort study using linked primary and secondary care data from the Clinical Practice Research Datalink in England. Maternal–child dyads were identified in these data. Maternal physical and mental health outcomes were identified in the primary and secondary care datasets using previously developed diagnostic coding frameworks. Incidence rates of the outcomes were modelled using Poisson regression, adjusting for deprivation, ethnicity and age and accounting for time at risk.ResultsA total of 35 683 mothers; 8950 had a child with a life-limiting condition, 8868 had a child with a chronic condition and 17 865 had a child with no long-term condition.The adjusted incidence rates of all of the physical and mental health conditions were significantly higher in the mothers of children with a life-limiting condition when compared with those mothers with a child with no long-term condition (eg, depression: incidence rate ratio (IRR) 1.21, 95% CI 1.13 to 1.30; cardiovascular disease: IRR 1.73, 95% CI 1.27 to 2.36; death in mothers: IRR 1.59, 95% CI 1.16 to 2.18).ConclusionThis study clearly demonstrates the higher incidence rates of common and serious physical and mental health problems and death in mothers of children with a life-limiting condition. Further research is required to understand how best to support these mothers, but healthcare providers should consider how they can target this population to provide preventative and treatment services.

scholarly journals Current understanding and implementation of ‘care navigation’ across England: a cross-sectional study of NHS clinical commissioning groups

2019 ◽  
Vol 69 (687) ◽  
pp. e675-e681 ◽  
Author(s):  
Stephanie Tierney ◽  
Geoff Wong ◽  
Kamal R Mahtani
Keyword(s):  
Cross Sectional Study ◽  
Descriptive Statistics ◽  
Sectional Study ◽  
Cross Sectional ◽  
Long Term Conditions ◽  
Health And Wellbeing ◽  
Medical Needs ◽  
Social Prescribing ◽  
Evaluation Of Care

BackgroundCare navigation is an avenue to link patients to activities or organisations that can help address non-medical needs affecting health and wellbeing. An understanding of how care navigation is being implemented across primary care is lacking.AimTo determine how ‘care navigation’ is interpreted and currently implemented by clinical commissioning groups (CCGs).Design and settingA cross-sectional study involving CCGs in England.MethodA questionnaire was sent to all CCGs inviting them to comment on who provided care navigation, the type of patients for whom care navigation was provided, how individuals were referred, and whether services were being evaluated. Responses were summarised using descriptive statistics.ResultsThe authors received usable responses from 83% of CCGs (n = 162), and of these >90% (n = 147) had some form of care navigation running in their area. A total of 75 different titles were used to describe the role. Most services were open to all adult patients, though particular groups may have been targeted; for example, people who are older and those with long-term conditions. Referrals tended to be made by a professional, or people were identified by a receptionist when they presented to a surgery. Evaluation of care navigation services was limited.ConclusionThere is a policy steer to engaging patients in social prescribing, using some form of care navigator to help with this. Results from this study highlight that, although this type of role is being provided, its implementation is heterogeneous. This could make comparison and the pooling of data on care navigation difficult. It may also leave patients unsure about what care navigation is about and how it could help them.

scholarly journals Exercise and pregnancy: information for practice nurses

2019 ◽  
Vol 30 (8) ◽  
pp. 379-384
Author(s):  
Clare Gordon
Keyword(s):  
Physical Activity ◽  
Pregnant Women ◽  
Physical Activities ◽  
World Health ◽  
Long Term Conditions ◽  
Practice Nurses ◽  
Health And Wellbeing ◽  
Health Organization ◽  
Diabetes And Obesity

Practice nurses are equipped to care for patients with long-term conditions such as diabetes, asthma and obesity. Therefore, says Clare Gordon, they are well placed to advise pregnant women on common physical activities they may undertake to maintain health and wellbeing It has long been recognised that regular physical activity and exercise enhance both physical and psychological wellbeing. The benefits of physical activity throughout the life span of an individual cannot be underestimated and it is no less important when a woman is planning to become, or is, pregnant. The World Health Organization (2010) note that physical inactivity is the fourth leading risk factor for global mortality and is attributed to 6% of deaths globally. This article explores the guidance for physical activity for the general population and how it then relates to the guidance available for women who are pregnant. This article considers some of the key benefits to a range of common physical activities that pregnant women may undertake. It also explores some of the information that practice nurses should be aware of and how physical activity may impact on several long-term health conditions such as asthma, diabetes and obesity.

scholarly journals Social prescribing in cardiology: rediscovering the nature within us

2019 ◽  
Vol 14 (8) ◽  
pp. 1-9 ◽  
Author(s):  
Michelle Howarth ◽  
Craig Lister
Keyword(s):  
Cardiovascular Disease ◽  
Decision Making ◽  
Social Prescribing ◽  
Fundamental Part ◽  
Novel Approach ◽  
Complementary Approach ◽  
What Matters

Personalised care is integral to the delivery of the NHS England Long Term Plan. Enabling choice and supporting patients to make decisions predicated on ‘what matters to them’, rather than ‘what is the matter with them’ is a fundamental part of the NHS vision. Social prescribing uses non-medical, asset-based, salutogenic approaches to promote this personalised paradigm, and places the patient central to decision making. This article discusses how personalised care can be used to help people with cardiovascular disease using socially prescribed ‘nature-based’ interventions to support the pre-habilitation and rehabilitation of patients with cardiovascular disease. The concept of personalised care outlined and the significance of salutogenic principles as a complementary approach to the pathogenic model is discussed. The authors argue that this seemingly novel approach to using nature-based interventions can help promote wellbeing for people with cardiovascular disease as part of the wider personalised agenda.

scholarly journals Nutra-ergonomics: influence of nutrition on physical employment standards and the health of workers

2016 ◽  
Vol 41 (6 (Suppl. 2)) ◽  
pp. S165-S174 ◽  
Author(s):  
Jane Shearer ◽  
Terry E. Graham ◽  
Tina L. Skinner
Keyword(s):  
Worker Safety ◽  
Work Schedule ◽  
Physical And Mental Health ◽  
Health And Wellbeing ◽  
Workplace Productivity ◽  
Employment Standards ◽  
Short And Long Term ◽  
And Performance

The importance of ergonomics across several scientific domains, including biomechanics, psychology, sociology, and physiology, have been extensively explored. However, the role of other factors that may influence the health and productivity of workers, such as nutrition, is generally overlooked. Nutra-ergonomics describes the interface between workers, their work environment, and performance in relation to their nutritional status. It considers nutrition to be an integral part of a safe and productive workplace that encompasses physical and mental health as well as the long-term wellbeing of workers. This review explores the knowledge, awareness, and common practices of nutrition, hydration, stimulants, and fortified product use employed prior to physical employment standards testing and within the workplace. The influence of these nutra-ergonomic strategies on physical employment standards, worker safety, and performance will be examined. Further, the roles, responsibilities, and implications for the applicant, worker, and the employer will be discussed within the context of nutra-ergonomics, with reference to the provision and sustainability of an environment conducive to optimize worker health and wellbeing. Beyond physical employment standards, workplace productivity, and performance, the influence of extended or chronic desynchronization (irregular or shift work) in the work schedule on metabolism and long-term health, including risk of developing chronic and complex diseases, is discussed. Finally, practical nutra-ergonomic strategies and recommendations for the applicant, worker, and employer alike will be provided to enhance the short- and long-term safety, performance, health, and wellbeing of workers.

scholarly journals The feasibility of assessing the Flinders Programme of Patient Self-Management in New Zealand primary care settings

2010 ◽  
Vol 2 (4) ◽  
pp. 294 ◽  
Author(s):  
Margaret Horsburgh ◽  
Janine Bycroft ◽  
Faith Mahony ◽  
Dianne Roy ◽  
Denise Miller ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practice ◽  
New Zealand ◽  
Self Management ◽  
Participant Recruitment ◽  
Practice Nurses ◽  
Management Capacity ◽  
Term Trial

INTRODUCTION: The Flinders ProgramTM has been adopted in New Zealand as a useful and appropriate approach for self-management with primary care clients who have chronic conditions. The Flinders ProgramTM has not been evaluated in New Zealand settings. AIM: To assess the feasibility of undertaking a substantive long-term trial to gauge the effectiveness of primary care nurses using the Flinders ProgramTM to improve health outcomes for New Zealand populations. METHODS: A pilot study was undertaken considering four components of feasibility of conducting a long-term trial: practice recruitment, participant recruitment, delivery of the intervention and outcome measures. This included comparing 27 intervention and 30 control patients with long-term health conditions with respect to change in self-management capacity—Partners in Health (PIH) scale—quality of care using the Patient Assessment of Chronic Illness Care (PACIC) scale and self-efficacy across six months. Intervention participants received care planning with practice nurses using the Flinders ProgramTM in general practices, while control participants received usual care in comparable practices. RESULTS: General practice and participant recruitment was challenging, together with a lack of organisational capacity and resources in general practice for the Flinders ProgramTM. The measures of self-management capacity (PIH), quality of care (PACIC) and self-efficacy were useful and valuable primary outcome measures. DISCUSSION: The overall findings do not support a substantive trial of the Flinders ProgramTM in primary care. Difficulties associated with participant recruitment and ability of practice nurses to undertake the Flinders ProgramTM within general practice need to be resolved. KEYWORDS: Self-management; long-term conditions; chronic conditions; chronic illness; primary care; nurses

scholarly journals Social prescribing: the whys, wherefores and implications

2019 ◽  
Vol 1 (2) ◽  
pp. 94-98 ◽  
Author(s):  
Michelle L Howarth ◽  
Helen Donovan
Keyword(s):  
Health And Wellbeing ◽  
Social Prescribing ◽  
Medical Approach

This article discusses social prescribing as a non-medical approach for prescribers that can promote health and wellbeing within a personalised care context as part of The NHS Long Term Plan. The concept of social prescribing and its origins will be described alongside common interventions and services. This article concludes with an exploration of how social prescribing can be used to compliment prescribing to support personalised care.

scholarly journals The Year of Care approach: developing a model and delivery programme for care and support planning in long term conditions within general practice

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Sue Roberts ◽  
Simon Eaton ◽  
Tracy Finch ◽  
Nick Lewis-Barned ◽  
Monique Lhussier ◽  
...  
Keyword(s):  
Health Care ◽  
General Practice ◽  
Health Care Professionals ◽  
Local Health ◽  
Implementation Framework ◽  
Long Term Conditions ◽  
Training Support ◽  
Care And Support ◽  
Health Communities

Abstract Background People with long term conditions (LTCs) make most of the daily decisions and carry out the activities which affect their health and quality of life. Only a fraction of each contact with a health care professional (HCP) is spent supporting this. This paper describes how care and support planning (CSP) and an implementation framework to redesign services, were developed to address this in UK general practice. Focussed on what is important to each individual, CSP brings together traditional clinical issues and the person’s lived experience in a solution focussed, forward looking conversation with an emphasis on ‘people not diseases’. Methods The components of CSP were developed in three health communities using diabetes as an exemplar. This model was extended and refined for other single conditions and multimorbidity across 40 sites and two nations, over 15 years. Working with local teams and communities the authors used theoretical models of care, implementation and spread, developing and tailoring training, support and resources to embed CSP as usual care, sharing learning across a community of practice. Results The purpose, content, process, developmental hurdles and impact of this CSP model are described, alongside an implementation strategy. There is now a robust, reproducible five step model; preparation, conversation, recording, actions and review. Uniquely, preparation, involving information sharing with time for reflection, enables an uncluttered conversation with a professional focussed on what is important to each person. The components of the Year of Care House act as a checklist for implementation, a metaphor for their interdependence and a flexible framework. Spreading CSP involved developing exemplar practices and building capacity across local health communities. These reported improved patient experience, practitioner job satisfaction, health behaviours and outcomes, teamwork, practice organisation, resource use, and links with wider community activities. Conclusions Tested in multiple settings, CSP is a reproducible and practical model of planned care applicable to all LTCs, with the capacity to be transformative for people with LTCs and health care professionals. It recaptures relational dimensions of care with transactional elements in the background. Options for applying this model and implementation framework at scale now need to be explored.

scholarly journals Social prescribing for autistic people: A framework for service provision

2021 ◽  
Vol 2 ◽  
pp. 19
Author(s):  
Rebecca A. Charlton ◽  
Catherine J. Crompton ◽  
Amanda Roestorf ◽  
Christopher Torry ◽  
Keyword(s):  
Service Provision ◽  
Psychosocial Support ◽  
Well Being ◽  
Health Conditions ◽  
Physical And Mental Health ◽  
Social Prescribing ◽  
Healthcare Needs ◽  
Autistic People ◽  
Autistic Adults ◽  
Mental Well Being

Social Prescribing (SP) is the referral of patients to non-clinical services for practical, physical or psychosocial support. Recent guidelines from the National Health Service England mean that SP will become commonplace for people with complex healthcare needs. Autistic adults make up over 1% of the population and commonly have co-existing physical and mental health conditions, therefore they are likely to be referred to SP services. As yet, no studies have examined the efficacy of SP for autistic adults. In this letter, we review the existing literature examining the efficacy of SP in the general population. We further examine the factors that should be considered when offering SP to autistic adults in order to optimise outcomes for physical and mental well-being.

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