Social Prescribing Link Workers across Lincolnshire

A proactive, preventative approach to social prescribing that will be determined by each PCN identifying patients who would benefit most from the support. The PCN will direct the capacity of the work for the social prescribing link work to ensure the population health needs are met. Social Prescribing Link Worker(s) will work in collaboration with their wider PCN based colleagues as part of a wider multi-disciplinary team. <br/><br/>Working as a member of the Primary Care Network Team the Social Prescribing Link Worker would enable GP Practices and other agencies to refer patients to support that identifies what matters to the person through shared decision making, personalised care and support planning. This support would connect the person to community-based informal support.<br/><br/>Social prescribing is a way to connect people with community-based services, groups and activities that meet practical, social, and emotional needs that affect their health and wellbeing, and increase people’s active involvement with their health and their community. It is a key component of personalised care where people have choice and control over the way their care is planned and delivered, based on ‘what matters’ to them and their individual strengths and needs.<br/><br/>The social prescribing provision is built around a localised team for each Primary Care Network,<br/>consisting of a Link Worker providing a provision in line with national good practice, embedding the following components:<br/><br/>

• Easy referral into primary care with each PCN directing the capacity of the work to support the health population needs of that PCN. <br/>
• Workforce development.<br/>
• Common outcomes framework.<br/>
• What matters to me (creating a personalised plan).<br/>
• Support for community groups.<br/>
• Collaborative commissioning and partnership working. Additional information: Indicated price does not include extension option

Working as a member of the Locality Mental Health Team, the primary aim of the MHSPLW role is to support people who are experiencing a serious mental illness (SMI) by providing the following:<br/>1. Support to people who are stepping down from Secondary Care (Mental Health) services to safely transition back into their communities as part of an agreed Locality Mental Health Team approach.<br/>2. Working alongside Primary Care or other community/neighbourhood colleagues, to support individuals who are complex and who may/or may not be in contact with Secondary Care Mental Health Services.<br/>3. A proactive, preventative approach to people who are experiencing mental health and wellbeing needs as part of the wider Locality Mental Health Team offer. <br/>4. Provide additional targeted social prescribing resource to supplement the Primary Care Network Social Prescribing Link Workers (PCN SPLWs). It is envisaged that each mental health social prescribing link worker will work in collaboration with their identified PCN based colleagues as part of a wider multi-disciplinary team, ensuring a no wrong door approach for those accessing them.<br/><br/>As part of a wider Multi-Disciplinary Team (MDT) within their respective Localities and across the continuum of care providing strong, person led, holistic approach to care, the MHSPLW roles will:<br/>a) Give people time to have a person-centered conversation focusing on ‘what matters to them’, in order to develop trusting relationships.<br/>b) Help people to identify issues that affect their mental health and wellbeing, and with them co-produce/feed into their personalised care and support plan (PCSP).<br/>c) Use coaching and motivational interviewing techniques to support people to take control of their own mental health and wellbeing.<br/>d) Support people by connecting them to community-based activities, groups and services, such as, specialist advice services and arts and culture, physical activity, and nature and green activities.<br/>e) Determine the length of support required for an individual in collaboration with the wider MDT/LMHT.<br/>f) Ensure a strong emphasis of self-efficacy is embedded as part of trauma informed practice.<br/>g) Where required and as appropriate (determined with the wider LMHT), refer/transfer people back to other health professionals, this could include taking decisions as to whether to escalate complex cases or not.<br/>h) Work collaboratively within the identified psychologically informed pathways across the continuum of care. <br/>i) Utilise Patient Related Outcome Measures such as the Individual Recovery Outcome Counter (i-ROC) and Goal Based Outcome.<br/>j) Manage and prioritise their own workload, in collaboration with their organisation.<br/>k) Attend meetings/panels to support service development.<br/>l) Be required to attend and engage with regular supervision.<br/>m) Following the intervention, send a brief summary detailing the outcome to the referrer. If a referral is not considered appropriate feedback on the reason will be clearly communicated to the referrer. The MHSPLW may in these cases undertake (Level 1) signposting to other more appropriate provision. <br/>n) All MHSPLWs role will be predominantly providing individual contact and support, it will be expected that the ratio of individual support to other activities will be no less than 80% (individual support) to 20% (other activities). Additional information: Indicated price does not include extension option