Co-design for social prescribing with Brisbane North PHN
Status: Completed December 2022
Client: Brisbane North PHN
Background
Brisbane North PHN identified social prescribing as an opportunity to respond to health and service system needs of the Brisbane North region that were uncovered during its 2021-22 Health Needs Assessment. The findings included social isolation and loneliness, chronic conditions. social determinants of health, patient activation and empowerment, coordination between services and service capacity.
Social prescribing is when a health professional, like a GP, refers a patient to someone (often called a Link Worker or Navigator) who works with the patient to identify their goals and interests and provides a non-medical prescription to improve their health and wellbeing.
In late 2022, BNPHN engaged our team to lead a co-design process that would identify the most appropriate model to commission, with a pilot project focused on the Caboolture region to consider scalability and evidence for a broader rollout.
Impact alignment
This project aligned with our vision of a “more impactful social purpose sector” by developing an innovative service model that is supported by an emerging evidence base to respond to the social and non-medical needs of people in the community.
Approach
Our project team worked closely with staff from Brisbane North PHN and subject matter expert Tracey Johnson, CEO of Inala Primary Care, to deliver the following:
Facilitate a series of co-design sessions with consumer and carer representatives, health professionals and other service providers to describe the target population and develop a model that best met their needs and preferences.
Undertake desktop research to highlight the strategic context of social prescribing in Australia, profile comparable models of social prescribing, and outline implementation learnings and success factors drawn from the emerging evidence base.
Provide Brisbane North PHN with a report and a recommended service model that could be piloted through a commissioning process to engage a suitable provider.
Project outcome
Through our review of the emerging evidence based around social prescribing both in Australia and internationally, combined with insights from local co-design workshops, key findings emerged that highlighted:
the benefits of engaging in non-medical activities or social supports, and the barriers or challenges that people report that make this difficult
how a social prescribing model could overcome these barriers and support people in the community to improve their wellbeing and reduce social isolation.
With these insights in mind, we designed an ideal model of social prescribing; a patient is referred or connected to a Link Worker who helps them to explore opportunities and co-produce a plan of non-medical activities and social supports that are aligned to the patients needs and interests. The patient is then supported and empowered to access the resources available within their own community to improve their social, emotional and physical health and wellbeing.
Brisbane North PHN have since undertaken a commissioning process to procure a suitable service provider to deliver the pilot in Caboolture.
Our team also provided guidance on a range of broader system changes required to progress the concept of social prescribing at a regional and national level such as:
engaging with primary care professionals
developing the emerging 'Link Worker' workforce
partnering with other agencies, such as local governments, community services and neighbourhood centres to promote non-medical activities and social supports
digital health initiatives that support streamlined referral, navigation and coordination
promotion and communication to raise awareness
monitoring, evaluation and learning.
