Partnership case study: ‘Community wellbeing service’ by Southdown

Southdown’s Community Wellbeing Service is co-located at multiple GP surgeries in Hastings, offering non-clinical support to patients with low-level mental health needs straight from their GP consultation. It promotes early support, health improvement and empowers patients to take control of their own health, helping to tackle long-standing health inequalities in Hastings.

Our challenge

Hastings and Rother CCG received a report produced by East Sussex Public Health Department about Reducing Health Inequalities in the area. It was recognised that people frequently presenting to GPs in Hastings were experiencing low levels of mental ill health that couldn’t be addressed with a purely clinical response. Mental ill health can lead to significantly poorer health outcomes and reduced quality of life.

The Community Wellbeing Service works with patients referred by their GPs to enable them to make sustainable changes to their social and economic situations that will result in better mental health and support mental health recovery.

Our solution

The Community Wellbeing Service (CWS) is funded by NHS Hastings and Rother CCG and offers a social prescribing model of support at nine GP surgeries in the Hastings area. The service is staffed by a coordinator and four advisors who are co-located within the GP surgeries. The team work alongside patients to link them into and engage with sources of support in the community.

The model continues to produce positive outcomes for patients and GPs, with 88% of patients reducing GP appointments regarding mental wellbeing and 100% of GPs agreeing that the service offers the type of non-clinical support required.

Our impact

The outcomes measured are:

  • number of people who receive the service
  • number of goals achieved
  • number of onward referrals
  • reduction in GP appointments
  • improvements in mental wellbeing

Data from the first year of delivery showed:

  • 236 people received the service
  • 345 goal outcomes achieved by patients
  • 553 onward referrals made
  • 88% of patients said that they had not returned to see their GP about their mental health
  • 75% of patients said that they had been supported to achieve their goals
  • 80% of GPs said that appointments of referred patients had reduced
  • 100% of GPs said that the CWS offered the right non-clinical support for their patients

During the second year of delivery, CWS are monitoring changes to the frequency of GP appointments pre and post intervention. Additionally, the short Warwick and Edinburgh Mental Wellbeing Scale is being used to monitor changes in patients’ mental wellbeing pre- and post-intervention.

Our partners

The CWS works in partnership with participating GPs in the Hastings area. By co-locating its advisors within the surgeries, the service seeks to

  • develop GPs’ understanding of using alternative or complimentary responses to mental distress
  • gain wider recognition of the influence of social, economic and cultural factors on mental health outcomes
  • improve GP and patient awareness of social prescribing, including how and when to access it for symptoms of mild to moderate  anxiety and depression, and other common mental health problems
  • develop links to voluntary and community sector as a means of helping to improve mental health and wellbeing

Our role

Southdown offers a range of tailored community-based services, including specialist housing support and mental health services across Sussex. This enables all Southdown services to share local knowledge, resources, contacts and networking opportunities.

The skilled CWS advisors support and empower patients to access to up-to-date and timely information that helps them plan and develop their personal goals and link with existing community support services.

By enabling patients to address their social and economic needs by developing their personal resilience and improving their knowledge and use of available services, patients are able to maintain and improve health, wellbeing and independence.

Our contribution to improving health

We believe the project addresses the following outcomes:

  • NHS 1.5, PHOF 4.9 - reducing premature mortality in people with mental illness
  • NHS 2.5, ASC 1F & 1A, PHOF 1.8 & 1.6 - enhancing quality of life for people with mental illness
  • NHS 3.1 - improving outcomes from planned treatments
  • NHS 4.7 -  improving experience of healthcare for people with mental illness

Hastings has been identified as an area of deprivation. People living in the poorest neighbourhoods in England will on average die seven years earlier than people living in the richest neighbourhoods. By developing patients’ resilience and ability to utilise services, the CWS hopes to reduce this health inequality and improve the quality and length of life of people living with mental illness.

The social prescribing model reinforces the ability of primary care to respond to patient’s needs and the CWS facilitate pathways to healthcare providers to improve patient experience.