Learning from practice

Summary

from an Evaluation of the CHAT Social Prescribing Scheme in Bradford South & West PCT November 2005 The Centre for Health Promotion Research Leeds Metropolitan University

A pilot social prescribing scheme has recently been set up in Bradford South and West Primary Care Trust (PCT). The aims of the scheme, called CHAT (Community Health Advice Team), are to broaden service provision for patients with non-clinical needs and to facilitate links between primary care and the voluntary sector.

The evaluation focused on the development of the scheme in the Ridge and Royds medical practices and used a case study design to examine the scheme from the perspectives of service users and health professionals. In addition, some data were gathered from key individuals involved in the first pilot scheme delivered by Healthy Lifestyle Healthy Living Centre at Dr Micallef & Partners, Highfield Health Centre. In total, 18 semi-structured interviews were carried out over a ten week period.

The evaluation suggests that CHAT is a valued scheme within the primary health care setting. There has been a steady flow of referrals in both practices and CHAT is being used by a diverse range of patients in terms of age, gender and social problems. The findings from the qualitative data show that the scheme is acceptable, relevant and appropriate from the perspective of staff and service users.

Patients and health care professionals perceive the CHAT scheme to be a successful bridge between primary care and the voluntary sector. In the interviews all patients expressed some form of positive outcome as a result of being on the scheme – reduced isolation, increased confidence, and access to non-stigmatised support were a few examples. Patients perceiving CHAT as an individual, caring service, tailored to their own appropriate needs, was a powerful indicator of its success.

Staff who took part in the evaluation discussed how the CHAT scheme had the potential to reduce workload and improve the quality of patientprofessional consultation. The benefits for staff having a ‘personalised, caring’ service were frequently cited as being one of the strengths of CHAT. CHAT provided access to a source of expert knowledge which was welcomed by staff. The benefits of the scheme to general practice were also highlighted iv by this evaluation. Having the scheme as an extension of primary health care adds further to the holistic work happening in these practices.

The current model of the scheme is working well and has been found to be acceptable and relevant. If the scheme was extended and potentially rolled out to other practices in the PCT it would be important that the core elements of the model developed in Bradford South and West were maintained. However, consistent and regular feedback for referrers is currently not being achieved and this is an issue which may need to be considered for future practice.

The CHAT model

Based in general practices.

Part of the Primary Health Care Team.

A visible service with a person known to the primary health care professionals in the practice.

Referral from any member of the multi-disciplinary team or self referral

Smooth referral process and patients seen quickly within a week to two weeks.

Skilled CHAT practitioner with good knowledge of the local community and voluntary sector and experience of supporting people.

Time spent with patients giving them an opportunity to explore solutions.

Ability to accompany patient on first visit to overcome barriers to access.

Current areas of good practice

No documents leave the practice, all referrals are dealt with internally.

Contact with patient is quick and efficient, usually within 2-7 days.

The initial assessment is lengthy and thorough and provides an opportunity for the patient to be listened to.

Patients are provided with a range of services within easy access to their local area. The offer of accompaniment is received positively by patients, especially those who lack self-esteem and confidence.