Article Text
Abstract
Aims and Objectives Nottingham City is one of the most deprived districts in England, exhibiting significant health inequalities among its Emergency Department (ED) population. To mitigate these disparities, Social Prescribing (SP) has been identified as a key initiative. SP connects individuals with community-based services and support to address wider determinants of health. Traditionally, SP is situated within primary care settings, raising the question of its potential effectiveness if integrated into the ED environment to reach the most disadvantaged populations.
Method and Design From June 2022 to August 2023, an ED-based Social Prescribing programme was implemented for individuals aged 11 and above attending the ED. The programme was delivered by three providers specialising in specific geographical areas, population groups, and community resources. SPs identified patients through ED staff referrals and screening electronic health records. Interactions occurred face-to-face during ED attendances or via telephone for out-of-hours referrals. The programme followed an iterative approach, continuously improving to enhance capacity, engagement, and evaluation.
Results and Conclusion Over the 14-month period, the service reached 1057 patients, 40% were from the most deprived quintile. Patients aged 18-25 years old, formed the biggest group using the SP service, with the over 70s being the second largest group (figure 1). The main reason for SP referral included mental wellbeing (30.7%), housing (14.7%), social isolation (11.4%), independent living (9.8%), and substance misuse (8.0%). These figures do not account for the multifaceted nature of most interactions. More than 200 community organisations received onward referrals. ED staff referrals increased by 39% during the pilot. Despite challenges in follow-up due to various factors affecting this patient group, staff feedback highlighted the positive impact on patients and the time saved by referring to community services. Preliminary findings suggest that SP significantly benefits ED patients, particularly those experiencing considerable health inequalities. Further evaluation is necessary to comprehensively assess this initiative.