Social Prescribing (Lincoln)

Code

MEDS3084

School

Medical Education Centre

Level

3

Credits

10

Semesters

Spring UK

Summary

Social prescription is an approach to healthcare that has been practiced for many years, however in the last few years its benefits and potential have been formally recognised by the NHS and plans to expand its provision and reach have been implemented as part of their national strategy.
In its simplest form Social Prescribing refers to the process through which patients are referred to non-clinical services based within their local community. The services themselves encompass a wide range of activities that include, but are not limited to, sports, art, music, volunteering, storytelling, meditation, yoga, gardening, and cookery.
While the referrals themselves are made by professionals from various services (i.e., emergency, employment and care-homes), the majority come from GP’s and are used to address issues connected with physical wellbeing, mental health, and social isolation.

This module will begin by providing students with a brief introduction to the history of social prescription, evidence of its effectiveness and value, as well as the manner in which it is currently being rolled out across the UK by the NHS. It will then move on to look at the different activities social prescription encompasses, the conditions it can be used to address, and the research which supports the efficacy of these approaches.
These sessions will also provide examples of local and national organisations that offer such services, and where possible include Q&A discussions with representatives from them. The last part of the module will focus on the procedural elements of social prescribing and where GPs, community & voluntary support services, and link workers are positioned in this process.
This section will also include Q&A discussions with representatives from these professions. In addition, it will consider the future of social prescription, particularly with regards to the obstacles it faces and the various ways in which it could be developed and deployed. The module will build on ongoing work within Lincoln Medical School to embed social prescribing curriculum content into the medicine programme, and it will enhance students’ awareness of the partnership working that happens across the region in this area. This optional module will also provide a mechanism for students interested in the topic to formalise their teaching with a credit bearing component.

Target Students

The Lincoln Medical School Students U6UMEDCNP4 (A10L)

Classes

• One 2-hour seminar each week for 10 weeks
• One 1-hour lecture each week for 10 weeks

Assessment

• 70% Coursework 1: The assessment for this module will operate in conjunction with the SP Link Worker Placement scheme being developed between LMS and Lincolnshire Social Prescribing lead organisation, Lincolnshire Community and Voluntary Service (LCVS).This scheme will pair students with a SP Link Worker on a voluntary basis for them to gain work experience of patient facing social prescribing referrals. Students undertaking this module will complete a case review of a patient that they are assigned by a Link Worker, or a GP. Based on what they have learned in the module they will consider and identify appropriate and available social prescription options. They will then meet with the patient to discuss these options and participate in the activities with them.Should the patient decide they do not want to engage with any of the available options, the student will still be required to gain first-hand experience of an activity they think would be beneficial for patient and discuss the rationale for their choice. The case study will be written up following standardised reporting guidelines to demonstrate the process of the prescription choice, the evidence base supporting the decision, and the relationship building process with the patient and Link Worker.(Maximum of 2000 words)
• 30% Presentation 1: The student will give a 10-minute presentation in which they explain the case they were assigned, the process of diagnosis and the research it was based on, as well as their experience of the activity and its impact. The presentation will be anonymised, and no patient information will be shared in it. (10 minutes)

Assessed by end of spring semester

Educational Aims

Learning Outcomes

The students will achieve learning outcomes within the GMC’s Outcomes for Graduates (2018) as follows (for “Newly qualified doctors” read “Students”):

Professional and ethical responsibilities 
2- Newly qualified doctors must demonstrate awareness of the importance of their personal physical and mental wellbeing and incorporate compassionate self-care into their personal and professional life.
They must demonstrate awareness of the need to: 
A: self-monitor, self-care and seek appropriate advice and support, including by being registered with a GP and engaging with them to maintain their own physical and mental health 
B: manage the personal and emotional challenges of coping with work and workload, uncertainty and change 
C: develop a range of coping strategies, such as reflection, debriefing, handing over to another colleague, peer support and asking for help, to recover from challenges and set-backs. 
 

Patient safety and quality improvement 
5 - Newly qualified doctors must demonstrate that they can practise safely. They must participate in and promote activity to improve the quality and safety of patient care and clinical outcomes. 
They must be able to: 
A: place patients’ needs and safety at the centre of the care process 
 

Dealing with complexity and uncertainty

6 - The nature of illness is complex and therefore the health and care of many patients is complicated and uncertain. Newly qualified doctors must be able to recognise complexity and uncertainty. And, through the process of seeking support and help from colleagues, learn to develop confidence in managing these situations and responding to change.

 
They must be able to: 
A:  recognise the complex medical needs, goals and priorities of patients, the factors that can affect a patient’s health and wellbeing and how these interact. These include psychological and sociological considerations that can also affect patients’ health 
B:  identify the need to adapt management proposals and strategies for dealing with health problems to take into consideration patients’ preferences, social needs, multiple morbidities, frailty and long term physical and mental conditions 
C: demonstrate working collaboratively with patients, their relatives, carers or other advocates, in planning their care, negotiating and sharing information appropriately and supporting patient self-care 
D: demonstrate working collaboratively with other health and care professionals and organisations when working with patients, particularly those with multiple morbidities, frailty and long term physical and mental conditions 
 

Safeguarding vulnerable patients

7 - Newly qualified doctors must be able to recognise and identify factors that suggest patient vulnerability and take action in response. 
They must be able to: 
B:  take a history that includes consideration of the patient’s autonomy, views and any associated vulnerability, and reflect this in the care plan and referrals 
E:  assess the needs of, and support required, for people with mental health conditions 
H:  recognise where addiction (to drugs, alcohol, smoking or other substances), poor nutrition, self- neglect, environmental exposure, or financial or social deprivation are contributing to ill health. And take action by seeking advice from colleagues and making appropriate referrals 
 

Leadership and team working

8 - Newly qualified doctors must recognise the role of doctors in contributing to the management and leadership of the health service. 
They must be able to: 
C:  recognise and show respect for the roles and expertise of other health and social care professionals and doctors from all specialties and care settings in the context of working and learning as a multi- professional team.
 

Communication and interpersonal skills

11 - Newly qualified doctors must be able to carry out an effective consultation with a patient. 
They must be able to: 
B:  encourage patients’ questions, discuss their understanding of their condition and treatment options, and take into account their ideas concerns, expectations, values and preferences 
C:  acknowledge and discuss information patients have gathered about their conditions and symptoms, taking a collaborative approach 
F:  work with patients, or their legal advocates, to agree how they want to be involved in decision making about their care and treatment 
 

Diagnosis and medical management

14 - Newly qualified doctors must be able to work collaboratively with patients, their relatives, carers or other advocates to make clinical judgements and decisions based on a holistic assessment of the patient and their needs, priorities and concerns, and appreciating the importance of the links between pathophysiological, psychological, spiritual, religious, social and cultural factors for each individual.

They must be able to: 
L:  propose a plan of management including prevention, treatment, management and discharge or continuing community care, according to established principles and best evidence, in collaboration with other health professionals if necessary 
M:  support and motivate the patient’s self-care by helping them to recognise the benefits of a healthy lifestyle and motivating behaviour change to improve health and include prevention in the patient’s management plan 
 

The health service and healthcare systems in the four countries

20 - Newly qualified doctors must demonstrate how patient care is delivered in the health service. 
They must be able to: 
A: describe and illustrate from their own professional experience the range of settings in which patients receive care, including in the community, in patients’ homes and in primary and secondary care provider settings 
B:  explain and illustrate from their own professional experience the importance of integrating patients’ care across different settings to ensure person-centred care 
C:  describe emerging trends in settings where care is provided, for example the shift for more care to be delivered in the community rather than in secondary care settings 
 

Applying social science principles

24 - Newly qualified doctors must be able to apply social science principles, methods and knowledge to medical practice and integrate these into patient care.

They must be able to:
A: recognise how society influences and determines the behaviour of individuals and groups and apply this to the care of patients 
B: review the sociological concepts of health, illness and disease and apply these to the care of patients 
D: recognise sociological factors that contribute to illness, the course of the disease and the success of treatment and apply these to the care of patients − including issues relating to health inequalities and the social determinants of health, the links between occupation and health, and the effects of poverty and affluence 
E: explain the sociological aspects of behavioural change and treatment concordance and compliance, and apply these models to the care of patients as part of person-centred decision making. 
 

Health promotion and illness prevention

25 - Newly qualified doctors must be able to apply the principles, methods and knowledge of population health and the improvement of health and sustainable healthcare to medical practice. 
They must be able to: 
A:  explain the concept of wellness or wellbeing as well as illness, and be able to help and empower people to achieve the best health possible, including promoting lifestyle changes such as smoking cessation, avoiding substance misuse and maintaining a healthy weight through physical activity and diet 
D:  assess, by taking a history, the environmental, social, psychological, behavioural and cultural factors influencing a patient’s presentation, and identify options to address these, including advocacy for those who are disempowered 
F:  outline the principles underlying the development of health, health service policy, and clinical guidelines, including principles of health economics, equity, and sustainable healthcare.
 

Clinical research and scholarship

26 Newly qualified doctors must be able to apply scientific method and approaches to medical research and integrate these with a range of sources of information used to make decisions for care. 
They must be able to: 
B:  interpret and communicate research evidence in a meaningful way for patients to support them in making informed decisions about treatment and management 
I: describe the concept of personalised medicine to deliver care tailored to the needs of individual patients 
J: use evidence from large scale public health reviews and other sources of public health data to inform decisions about the care of individual patients. 
 

Conveners

• Professor David O'Brien