By Sarah Robens, Evaluation Lead and Spread Fellow, South West Academic Health Science Network
For over five years, St Austell Healthcare, a general practice in St Austell, Cornwall, has been taking a different approach to providing primary care services to the 30,000 residents of the market town.
Driven by the challenge of recruiting GPs, the practice team has been working to improve the health and wellbeing of its patients by enabling easier access to non-medical support in the community - an approach known as social prescribing. This initiative, led by social prescribing link workers and volunteers at the practice, is supported by the South West Academic Health Science Network (SW AHSN) through its Institute for Social Prescribing.
At the SW AHSN we have been capturing insights from local sites belonging to the Institute for Social Prescribing during COVID-19, including St Austell. I’ve been inspired by the amount of learning that has come from communities like St Austell during the last few months. We are seeing practical and strategic examples of teams finding points in their working systems where they can adjust what they are doing.
In particular, we are seeing multiple layers of activity in which teams are not just jumping to solutions, but are building on their understanding of their community, system and the people they work with, the ways in which they think and behave and then putting in place systems that really meet need. These kinds of insightful activities provide leverage for real change for people on the ground, especially those who may be particularly vulnerable during COVID-19 or more historically suffer from health inequalities.
Parts of St Austell are in the top 10% most deprived areas in England.
In St Austell, nearly a quarter of residents live with a long-term health condition and many are reliant on face-to-face activities and support for their health and wellbeing. When the emergence of COVID-19 limited face-to-face contact, it left thousands of local residents in danger of being isolated at home. The social prescribing team at St Austell Healthcare realised they had a central role to play in meeting the needs of the most vulnerable but, given the situation, they had to stop the support they were currently delivering in person and begin something else.
A combination of repurposing digital technology, prioritising the needs of the local community residents, making personal approaches to people deemed at risk from COVID-19, and working in partnership with clear processes in place. Together these created an effective and rapid response to the impact of COVID-19 on local residents in St Austell.
Working with mobile app developers, the team quickly repurposed their existing mobile app, Help at Hand, within just a few days. The app, a directory of the latest support services in St Austell available by telephone and online, became a useful tool for the town and its health and care professionals.
“[Help at Hand] was a great resource…we were able to share details of what support was out there.” Mel Bond, Link Worker, St Austell Health Care.
At the same time the team grew concerned about where to start to respond, given the high percentage of people in the town with pre-existing health conditions leaving them at disproportionately high risk of COVID-19. Again, they turned to technical colleagues to assist. Working with the St Austell Healthcare data manager, the team systematically identified and prioritised people in the town that might need support.
But even with this prioritisation, meeting the potentially high demand for support remained a daunting task. To help solve the challenge, the social prescribing team worked in partnership with local charity Volunteer Cornwall to create a combined team of staff and volunteers to contact people and deliver food, medicine or just to provide a friendly chat where it was needed. An existing relationship between St Austell Healthcare and Volunteer Cornwall, built from their location at the same site, provided a solid foundation for the team to build on in the crisis.
1,600 calls have been made to check whether people need support and volunteers deliver prescriptions for around 300 people.
A protocol document setting out different processes was developed to help the social prescribing team and wider surgery staff. The protocol included features like a script for telephone calls and a process for how the 120 staff at the practice could flag a patient or resident who would benefit from being contacted. This was particularly useful for developing and detailing processes for each of the five pharmacies in St Austell, which was a challenge as they all operate in different ways.
“Working in partnership with St Austell Healthcare meant that vulnerable and isolated members of the community were able to be identified early on and the required support put in place quickly.” Gemma Sutcliffe, High Intensity User Coordinator from Volunteer Cornwall
By taking the approach they did - to combine the best of data, digital technology, people, partnership, and process - hundreds of vulnerable people in St Austell have been supported during the COVID-19 crisis. No one element could have achieved this on its own. Instead it is the combination of all working well together that seems to have made the difference.
You can read the full experience of St Austell Healthcare’s social prescribing team during COVID-19 by downloading our case study. Our thanks to Hayley Burgoyne, Head of Social Prescribing at St Austell Healthcare, for sharing their learning at this point.
St Austell Healthcare have participated in the South West Academic Health Science Network (SW AHSN)’s Spread Academy, an immersive training course designed to equip teams and leaders in health and care with the skills they need to unleash large-scale change.
During COVID-19, the SW AHSN has been inviting organisations from across the South West to participate in an exercise on rapid cycle learning – a way of capturing and transferring knowledge to continually improve a system. Some of the first participants in our study are from the test beds of our Institute for Social Prescribing. Click here to download the learning highlights.
About St Austell
- St Austell is a market town in south Cornwall.
- It is close to the coast and local attractions like the Eden Project.
- St Austell Healthcare provides primary care services to the 30,000 residents of the town
- There are currently around 3,200 patients per GP, double the England average.
- There are more people over the age of 65 in St Austell than in England as a whole, but the proportion of children and young people is around the national average.
- Parts of St Austell are in the most deprived 10% of all areas in England. In these areas life expectancy is lower with people dying up to 9 years earlier than elsewhere.
- 23% of people in St Austell have a life-limiting long-term health condition, compared to 18% nationally.