• 871731000000106 – Referral to social prescribing service (procedure) – To be used when an individual accepts a referral to the SPLW– for first interaction in an episode of care only, not to be used to code ongoing activity.
• 871711000000103 – Social prescribing declined (situation) – To be used when an individual declines a referral to the SPLW.

1. SNOMED code 871731000000106 Referral to Social Prescribing (procedure) should not be used to code activity previously provided to support this group of people, such as welfare calls.
2. The above SNOMED code should not be used when SPLW completes mass booking of appointments through brief calls that do not lead to a conversation about the vaccine or support needs to attend for an appointment, collating lists of vulnerable patients, supporting volunteers and marshalling vaccination centres. This activity should be recorded using an alternative method as directed by your employer e.g. through collecting case studies of SPLW involvement as it cannot be recorded against individuals.
3. Undertaking administrative tasks such as booking appointments should not be coded on GP IT systems as social prescribing activity, unless they include the examples mentioned in the section Coding Activity for the COVID-19 Vaccination Programme here.

One of the most important aspects in a profession such as Social Prescribing is to invest in continuous professional development. There are numerous possibilities (and many of them are free of charge) to stay well informed, equipped with the newest tools and techniques and open to innovation.

One of the first training all SPLWs should complete is Social Prescribing – Learning for Link Workers (SPL) (join here) offered online by e-LfH (Health Education England Programme in partnership with the NHS and Professional Bodies). We also encourage you to participate in and/or watch Social Prescribing NHSE Webinars (available here) and access monthly Peer Learning sessions (recordings here, sign up here).

In order to support you in finding training opportunities, we have created a Social Prescribing Training And Development matrix you could use to search through available options. We do not endorse any training providers but rather present a summary of resources that SPLWs found useful to share with others.

We hope you will find it useful!

Considering the complexity of the SPLW role, the variety of professionals to connect with and the demands on Primary Care right now, developing these crucial relationships can be challenging – especially during the pandemic while face to face interactions are limited.

We recently hosted a Peer Learning Session to discuss this topic. A group of social prescribing link workers, their managers and some clinical staff from Primary Care, gathered to discuss the components of developing social prescribing allies with PCNs, sharing examples of their work and discussing top tips to overcome challenging situations.  There are some key slides below & you can watch the recording here: “Developing Social Prescribing Allies within your PCN” (28th May 2021).

Training Hubs, formerly known as Community Education Provider Networks or CEPNs, are organisations commissioned at a borough or STP/ICS level to support multidisciplinary primary care teams (amongst others including community and social care providers).  Their aim is to enhance training, education and workforce development, and work with local systems to develop effective, innovative initiatives to support priorities as follows:

• Workforce planning: Training hubs can support the planning and development of the workforce in response to local and national need and inform relevant strategies to enable the redesign of services within primary care and the community.
• Career support and retention: Training hubs can contribute to the development and retention of the workforce through delivery of ICS/STPs’ and PCNs’ commissioned initiatives, including leadership programmes and peer support programmes.
• Embedding new roles: Training hubs can be commissioned to support ICS/STPs and PCNs to embed the new roles in general practice by coordinating, delivering, and managing training and development opportunities for these new roles.

They are a fantastic source of training and development opportunities and are interested in hearing about the challenges that primary care staff face, as well as examples of best practice that they can support to proliferate.

• If you are an SPLW – see if your local training hub has a newsletter you can sign up for to know more about what is on offer
• If you manage a social prescribing service, do you know who your local (borough level) training hub lead is?  If not – let us know and we will put you in touch
• If you are an SPLW working directly for a PCN, and you are struggling, you might want to flag your experience with the training hub – let us know and we will put you in touch

We are looking for some case studies of training hubs supporting the social prescribing workforce – tell us more about what is working: lianna.martin@nhs.net

Effective social prescribing is not just about the call you are making.  It is also about reading in advance, writing up the notes, researching organisations and building relationships with organisations in the community that you can refer people to.

You are also likely to need more time for the first session you have with a new referral, but 45mins – 1 hour per session will allow you send time building rapport, gaining trust and exploring what is important to the individual, and an additional 30 mins for follow up is ideal (please see Bromley by Bow’s suggested telephone script and pre recorded online training).

You may not always need this, but as complexity of cases grows, it is important to allow yourself this time in order to ensure you and the patient have the proper time to do ‘social prescribing’ and not a quick welfare check.

For those wanting to build the case for more time with your clients:

The SPLW role assess non medical needs through a thorough assessment that includes household income, debt, relationships at home, housing situation, any crisis needs, as well as discussing solutions in a person centred way.

This takes time, not only to conduct a session, to input into Emis, SystmOne and whatever local systems you might also be using, and then make sure you have follow up calls booked in.  This doesn’t even take into account referral conversations, research into local services and general mapping.  One thing is clear, outside of Covid crisis response, 20min sessions back to back cannot be called ‘social prescribing’.

Resources you can turn to build your case: 
There is a page on the NHS website dedicated to ‘Supporting Link Workers in Primary Care Settings’.

There are lots of different resources to support the implementation of social prescribing both for Link Workers, service managers, Clinical Leads, practice staff and so on.  I am sending this link so you can have a nose around yourself, but might also be useful to share.

More specifically, NHS England has published a couple of documents relevant to your query.

• Social prescribing summary / implementation guide – p.13 – 14 references ‘Link Workers are employed to give time’, and on p.14 outlines the following with regard to workload:
  ‘Workload. Link workers typically work with people over 6-12 contacts (including phone calls and meetings) over a three-month period (depending on what the person needs) with a typical annual caseload of up to 250 people, depending on the complexity of people’s needs and the maturity of the social prescribing scheme.’
• PCN social prescribing reference guide– references the role of the SPLW as ‘giving time’ to patients (p.5)
• Technical annex for social prescribing – Just lots of useful docs for the PCN to make them realise this is a serious and weighty role!!!

Some suggestions for how you might approach 

• Ensure you are attending the MDT meetings
• Create a short presentation for your PCN around what social prescribing is and how you might be able to support them
• Think about how you might be able to support the surgery in solving issues they struggle with, such as targeting ‘frequent attenders’ so you can start to demonstrate how you work can positively impact theirs
• Some SPLW I know have invited GPs and CDs to shadow their sessions which has had very positive impact

As Social Prescribing Link Worker you are not expected to treat suicidal thoughts but you can contribute to helping the person by referring or signposting to an institution specialising in supporting someone who feels suicidal. However, your work may focus on encouraging the person to accept suitable support. Make sure you have an up to date information on your local services including: Mental Health Crisis Team, Single Point of Access (SPA), Samaritans, Papyrus, CALM National Suicide Prevention Helpline UK , SHOUT or other local organisations.

It is crucial that you keep in mind a few important aspects of supporting someone who feels suicidal:

1. Follow your organisation’s safeguarding procedure and know your safeguarding lead
2. Make sure you make the person feel comfortable sharing suicide-related information
3. Provide the person with appropriate self-help resources
4. Make sure to update the GP system (e.g. Emis, SystmOne) with the information on your patient/client suicidal thoughts/attempts
5. Following a meeting with someone who feels suicidal contact your duty GP at the surgery on the same day. It is essential that SPLWs document that a clinician was informed of the situation and the signposting advice that the patient was given.
6. Consider reviewing the referral with your GP Supervisor/Mentor
7. For your personal well-being it is advised that you do check in with a line manager or Clinical Director after having intense meetings or calls involving discussing suicide.
8. If you feel unsure how to work with people who feel suicidal please consider additional training. Feel free to access SP Training and Development Matrix available here or if you need support for yourself please see our “Looking after yourself” page here.

• Approach your local CVS – an organisation working at a borough level, to support the frontline voluntary, community and social enterprise sector. London Plus website provides a comprehensive list of such organisations and their details (please note – not all boroughs will have a CVS): https://londonplus.org/cvs-and-volunteer-centres.
• Check what resources your local authority have collated – all councils have a remit to create a directory of local assets and services – perhaps you can use this as your base list or support by adding to it
• Connect with other SPLWs and social prescribers in your borough – many SPLWs have created a shared directory of services despite working for different organisations.  Create a spreadsheet shared on Teams, or a google map with a pin for each of the services SPLWs can refer to

NHSE SP Bulletin (20 January 2022, edition 42) addresses the COVID-19 vaccination requirement for SPLWs: “In November, the Department of Health and Social Care (DHSC) announced that individuals in patient-facing roles that form part of a CQC regulated activity or service in England must be fully vaccinated against COVID-19 no later than 1 April 2022, known as Vaccination as a Condition of Deployment (VCOD). Further guidance has been issued on implementation of the VCOD on the 14^th January.

The VCOD requirement includes SPLWs employed by primary care, either directly or via a sub-contract, and may apply to SPLWs working outside primary care if they work in or as part of a CQC regulated activity or service. The Registered Manager of a CQC-regulated service is responsible for deciding which roles are in scope of the VCOD requirement.

Some people may be exempt from the VCOD requirement. Reasons for exemption include:

• Those who are clinically exempt from COVID-19 vaccination
• Those who have taken part or are currently taking part in a clinical trial for a COVID-19 vaccine
• Those who do not have direct, face to face contact with a service user, for example, those providing care remotely, such as through triage or telephone consultations or managerial staff working in sites apart from patient areas

Employers and SPLWs can access Frequently Asked Questions about why the VCOD has been introduced, who the VCOD regulations apply to, further exemption criteria, who is responsible for ensuring the VCOD requirements are met, and information about volunteer VCOD requirements. Resources to encourage vaccination uptake are also available.

SPLW employers can access a newly-created VCOD workspace on the FutureNHS web platform by emailing nhsei.peopledirectorate@nhs.net. The workspace contains relevant policy information, guidance and supporting resources, and a discussion forum.

Further guidance will be available on The Platform in due course, including VCOD scenarios applicable to the VCSE sector. Please note that the Social Prescribing team are unable to answer questions about individual circumstances or contract arrangements or whether a role falls in or out of the VCOD scope, and SPLWs should contact their employer to discuss.”

You may also consider joining “Vaccination as a Condition of Deployment (VCOD) for Healthcare Workers” workspace on the FutureNHS Collaboration Platform to receive regular updates.