What do they do?
Bolton’s version of social prescribing, the Community Asset Navigators programme (CANs) is delivered through a partnership of local organisations, Bolton Community and Voluntary Services (CVS), Bolton Wanderers Community Trust, The Octagon, BAND, Age UK Bolton and Bolton Lads and Girls Club.
What is the aim of the project?
Social prescribing is about supporting someone to connect to their local community and to take part in an activity that makes them feel good about themselves and helps keep them well, with people often being able to manage long term conditions better and needing to go to the GP less often.
This programme aims to deliver and test a model of social prescribing that connects people, services and support to non-clinical assets in Bolton to improve their health, wellbeing and happiness. By evidencing what is and isn’t successful, the programme will utilise the learning to influence future models of social prescribing provision in Bolton.
How did they identify the need for the project?
The CANs programme has formalized a long standing history of social prescribing provision by the VCSE sector within the Bolton locality. Due to their early involvement in the development of Bolton’s locality plans, Bolton CVS were able to engage with their statutory partners and identify local needs and gaps in service provision from which asset based, sustainable solutions and services were developed to meet those specific needs and to eliminate the gaps through a structured, funded model in order to see what difference that would make.
How did it begin?
The CANs programme started in January 2018 funded by Greater Manchester Transformation funding. This innovative piece of work is led by Bolton CVS, in partnership five other local VCSE organisations (mentioned above), and collaboration with Bolton Council, NHS Bolton, Clinical Commissioning Group, Bolton GP Federation, Healthwatch Bolton and NHS Bolton Foundation Trust.
Each partner hosts a Community Asset Navigator who has a deep knowledge of their communities, a strong understanding of what’s available in their specialist areas, this combined with the knowledge of provision, capacity and availability through Bolton CVS’s work, ensures that the programme can connect people to the most suitable offer by using a person centered, strength based approach. The programme also identifies gaps in its offering and highlights areas for development in the sector that subsequently increases the sustainability of the project and the VCSE sector.
"I can't thank you enough, I am attending the Chair based exercise, Knit & Natter and the Arts & Crafts group on a weekly basis. I meet quite a few people and we have a bit of a natter and a laugh. I feel that my confidence has grown and I am able to deal with situations a lot better than I use to and have seen an improvement in my wellbeing. Thank you so much for visiting me and directing me to such groups.” Elise Keeton – Beneficiary at 6 month review
Who are the beneficiaries?
The CANs programme is open to everyone with a Bolton postcode. The most significant number of referrals into the programme come from GP’s and other NHS sources, such as practice nurses, district nurses and community teams, but also come via a simple self-referral process and a variety of other routes, including from community groups.
There are no exclusion criteria, the service to open to anyone who wants or needs to connect to their local community or community based services. The type of individuals who access the programme can therefore vary from those with complex needs to those who just want to obtain information about local groups and services.
Why is it different / special?
One of the key differences is that this programme is led by an infrastructure organisation, (Bolton CVS), in partnership with VCSE organisations in Bolton. This has enabled the programme to import key strengths from the partner organisations, whilst the CVS has been able to provide connections to grants, groups and practitioners to ensure that the social prescribing offer in Bolton is the best possible to meet the needs of residents.
CANs adopt a person centered, flexible approach that concentrates on finding out more about what makes people feel good about themselves and what helps keep them well and then connecting them to local services and facilitators to enable them to achieve their goals. The client is put at the heart of all interventions. There is a strong desire by the programme team not to ‘over prescribe’, instead concentrating on meeting the immediate needs that client has communicated through strength based, goal setting conversations.
“We sign post patients to the programme who need a little support accessing services that differ from health care. I think the CVS programme is of great benefit to people in the community, as it helps people connect and get involved in their community, reducing social isolation and increasing health and well-being.” Sophie Hall – OT, Bolton NHS Foundation Trust
Whilst the programme is not a medical model, it has needed to develop strong connections with healthcare professionals across Bolton. The co-design of the programme together with the Bolton GP’s Federation has resulted in the introduction of social prescribing prescription pads and simple referral protocols that has elicited a strong ‘buy-in’ from GP’s and other medical professionals. Ongoing collaboration, review and ‘sense checking’ with other local VCSE sector organisations and neighbourhood groups, through organisations, such as Healthwatch, have helped to establish what a good social prescribing model should look like which can, in turn, influence any future model of social prescribing provision in Bolton.
What challenges have they faced? How did they overcome them?
One of the major challenges faced by the programme was to improve the relationship between the VCSE sector and healthcare professionals in Bolton, making them aware of what services the sector could provide, Significant time and effort to build relationships with the VCSE sector was invested by CANs who have attended meetings across public sector and health and social care teams. The success of their efforts can be evidenced by the fact that, during the period 1st January 2018 - 31st March 2019, 70.9% of referrals into the programme during this period came from NHS sources, with 33% of referrals coming in from GPs and the Primary Care workforce.
The responsiveness of the programme, where referrals are responded to within five working days, has created a false perception amongst some referral agencies and clients that the programme can offer long term assistance to clients presenting with mental health issues, offering crisis support and managing caseloads in the same way as Key Workers. These occurrences have been fed back to the programme’s statutory partners to ensure that they understand this is not the role of CANs programme and also to make them aware of gaps in service provision. Similar conversations have also taken place with referral agencies to manage their expectations of the programme’s ensure people are referred into the programme at the best time for them.
What successes / outcomes have they had?
The programme’s Reach, Progress and Outcomes report for the period clearly shows the impact of the CANS programme in Bolton during the period 1st January 2018 - 31st March 2019. Headline statistics include;
1242 referrals being made to the programme which resulted in
3034 navigations to community interventions that resulted in
972 individual cases being managed and closed without referral to medical interventions
Over recent months the profile of social prescribing has increased across all partners in Bolton together with a recognition that it plays an important role in improving people’s health and well-being alongside medical interventions. Within Bolton new ways of working are being developed that increasingly understand the importance of strength-based working and connecting people to their communities. The CANs programme delivers a quality and sustainable offer of social prescribing rooted in the voluntary and community sector thereby increasing its profile and presence within the health and social care agenda in Bolton.
Find out more
For more information, visit www.boltoncvs.org.uk/cans