Plans by NHS England to recruit 1,000 new "link workers" by 2020/21 could spark an expansion of "social prescribing" schemes for children and young people.
Social prescribing aims to relieve pressure on NHS services by helping patients find suitable community activities to improve their health and wellbeing.
Last year, the government announced £4.5m to set up social prescribing schemes, with 23 projects across the UK so far being awarded a share of the funding.
Only one of these, led by youth charity StreetGames, works directly with young people - but Health Secretary Matt Hancock is an advocate of the approach and wants to establish a National Academy for Social Prescribing to expand its use more widely.
The StreetGames project is run in partnership with local youth and community charities in four areas - Brighton & Hove, Luton, Sheffield and Southampton. It is using its share of the £4.5m to recruit four link workers who will refer young people who present to GP surgeries with conditions that are not directly clinical to a range of social, cultural and sports activities in an effort to improve their quality of life and wellbeing.
GUIDE TO SOCIAL PRESCRIBING
- Government has pledged £4.5m investment in 23 schemes
- Primary care networks will have access to a social prescriber link worker who will work with patients
- NHS England will fund the recruitment of 1,000 new link workers by 2020/21
- 900,000 patient appointments expected to be handled by social prescribers by 2023/24
- Link workers form part of NHS England's plans to personalise care
- Patients can be "prescribed" social, cultural and sporting activities to improve health and wellbeing
NHS bosses are hoping the social prescribing approach will reduce demand on already stretched health services. A recent study carried out in Rotherham found 80 per cent of patients, within three to four months of being referred to a social prescribing scheme, had reduced their use of hospital admissions and appointments.
While social prescribing has been focused on addressing loneliness, social isolation and mental health problems for adults, Paul Jarvis-Beesley, head of health at StreetGames, says the approach has benefits for children and young people.
"We took a view that there's a lot going on for young people that is social in its origin rather than medical, but is holding them back in many ways and ultimately affecting their health," he explains.
"It's also about recognising that for young people this impacts beyond their encounters with the health system - their difficulties are affecting their education, and their chances to get decent training and jobs.
"It's perhaps driving them onto the street or getting them into trouble with the police," he says.
Each of the charity's four link workers will be expected to take on a caseload of around 200 young people annually, offering them an average of between four and eight support sessions.
Using partner organisations in each of the four areas - the only scheme of its kind to work across multiple locations - means that young people can access the social prescribing service via established community settings, not just GP clinics, Jarvis-Beesley says.
"Young people do turn up at GP surgeries - but it could be a teacher, youth worker, community worker or school nurse, any number of people who has contact with that young person," he says.
"Anybody can refer in, but something needs to trigger that referral - there has to be a sign of something not going quite right for the young person," he says.
The "open door" scheme will reach disadvantaged groups of young people through StreetGames' long-standing ethos to locate projects in areas of high disadvantage.
"That means the large number of young people who will come into the scheme will be facing those issues, and the social and health inequalities that come with it," says Jarvis-Beesley.
Young people could be "prescribed" sports activities, drama workshops, conservation work or volunteering roles. In addition, they can access counselling and housing advice, as well as help with improving fundamental skills such as literacy.
"It will be based on discussion with the link worker to find out what's going on with the young person and that does take some digging - realistically the link worker has to know what is available in the local area," he says.
Some of the funding for the first year will be allocated towards "sustaining" local activities as well as setting up new ones.
To meet the funding criteria outlined by the Department of Health and Social Care, local authorities and clinical commissioning groups (CCGs) in the four areas have agreed to match fund beyond the scheme's first year.
A budget of around £300,000 will fund the schemes for year one, reducing by 50 per cent for year two and then 80 per cent by year three. From year four, funding for the scheme will be entirely covered by local authorities, CCGs and other statutory partners.
"If we can demonstrate that it's working, there are real savings to be made - social prescribing for adults has already delivered some impressive results in terms of reduced attendance figures," says Jarvis-Beesley.
However, he says the scheme is "firmly held" within the NHS and growth needs to be encouraged to other sectors. "GPs are not the only port of call and if the system is properly communicated, anyone should be able to refer a young person for support."