Bringing the whole person into the room

Today on Social Prescribing Day, we met Alex Trigg, a Link Worker at the Bromley By Bow Centre, to get down to the nitty gritty of social prescribing, a progressive and growing healthcare function that links people to the full range of support their community has to offer.

Tell us a bit about what link workers or ‘social prescribers’ do?

We connect people with local services. So it’s about knowing what’s in the area, engaging with those local services, making referrals and signposting. We also support with behaviour change, so if there’s something people are struggling with, we offer up to six sessions of support and structured conversations, drawing out their own ability to make those changes. We have lots of tools we can use, including motivational interviewing and health coaching.

Why do we need social prescribing?

I love social prescribing because I’m able to give people time to talk. A lot of people need time for someone to listen and hear what they have to say - not necessarily jump in and offer solutions. Last week I spoke to somebody and I only signposted them to one or two places, but afterwards he said ‘thank you for listening to me.’ With GPs, it’s not having a go at them, but there are 10 minutes for the person to talk about themselves, and people go away not satisfied, unless it’s a tiny problem. We have 45 minutes, and you can go a long way with that.

What sorts of things have you helped people with?

Sometimes it’s about trying to reframe a situation. Small changes you can make to start to feel better - what could those changes be? They’re the experts in their own lives. Someone I worked with for a long time initially came because she was struggling with her degree. But as appointments progressed there were multiple complex issues regarding safety and welfare. She was appreciative and found it helpful to be able to turn to me, that there was less of a weight to bear.

What are the challenges?

I used to socially prescribe elsewhere, and Tower Hamlets has a lot more resources than most boroughs. The biggest challenge for me is managing expectations. We’re not advice workers, we can’t make everything better straight away, and sometimes service users think that’s going to happen. My least favourite referrals are about financial difficulties and housing. Because it’s not going to be solved in one go. Also there is a lot of need, and that can’t all be met. There are gaps in services. For example there are no children’s weight management services. This borough is very poor, and a healthy lifestyle and healthy food are expensive and inaccessible for a lot of people in this borough. 

So how does somebody access support?

Mostly we get referrals through the GP, and the GP will offer the patient that service. Or, they can call or email and self-refer. We also get referrals from physiotherapists and practice nurses. 

Can people working for other local services refer somebody to you?

We would welcome that! Not all social prescribers will take outside referrals, but some will. If somebody working for a local service reached out, they could be invited to a team meeting, where all the social prescribers in Tower Hamlets would attend and they could talk about what they do, and ask any questions.

Does everybody who could benefit know about social prescribing?

Probably not! I’ll be honest, a lot more could be done to speak about social prescribing nationally. While the Bromley By Bow Centre is quite well known for social prescribing, it doesn’t mean that everyone knows we’re here. Asylum seekers and refugees who may be afraid of approaching an official service like a GP might not be in touch with our services. Also, the word ‘social’ can put people off because it sounds like social services. 

How do you think social prescribers could further their reach?

A huge part of it is getting to know the area around you and where to send people. There’s no time for that if you’re struggling to meet targets. It’s not a problem for us, but I’ve heard of it being an issue elsewhere. Until we’re allowed time to get out of the GP environment and into the community, it’s going to be difficult.