To get the best out of peer and community support there needs to be a wide and appropriate range of support available, that meets the different needs and preferences of local people.
This means that work needs to be undertaken at a population level to understand what services and support are needed by different communities and to ensure that these are funded and supported accordingly.
The Health Foundation’s Co-creating Health programme found that some of the activities needed to create a menu of appropriate support locally included:
- Develop a nuanced understanding of co-production and the various ways in which people with long term conditions can support the different aspects of self-management support.
- Take stock of local and wider support systems for patient involvement and peer support, and utilise these to create a robust infrastructure and reduce potential risks.
- When developing programmes to support self-management as a whole, ensure that the role and potential value of peer and community support are understood and that associated costs are built in.
- When developing specific peer support activities, put systems in place to enable involvement and peer activities to be costed and evaluated. Costs include staff time, reimbursement of volunteer costs, support costs and spending on room hire, etc.
Peer and community support also needs to be routinely integrated into the healthcare system and care pathways. Approaches often include providing a single point of access to a range of options, such as:
- Social prescribing – the healthcare professional and person identify together the type of activities that will be of benefit, with the professional writing a ‘prescription’ directly to a service or referring the individual to an intermediary, such as a link worker, with whom a package of services can be constructed. A report by NESTA suggests that 90% of GPs thought that patients would benefit from social prescriptions while only 9% of patients have been given a social prescription, so there is considerable work ahead to mainstream this valuable approach.
- Signposting – signposting acts as a bridge between healthcare professionals and the social activities available, and can be performed by a variety of people including health trainers, wellbeing coaches, navigators, and voluntary community services networks.
Other approaches including reviewing care pathways to see how and where information about peer support activities can be built in, and including information about practical opportunities for involvement and peer activities into training for patients and practitioner development.
The Health Foundation’s Co-creating Health programme also found that there are some key approaches that can help services to link people into peer and community support as part of how the service is provided:
- Enable a culture that values and promotes all kinds of peer support, both formal and informal, and make links with local networks that can contribute to this.
- Ensure all those involved in self-management support understand the contribution of patient involvement / peer support, including its potential value and possible problems/risks – from clinicians incorporating it into their clinical practice to managers, clinicians and people with long term conditions working together to incorporate self-management support into the care pathway.
- Build understanding and awareness of the value and contribution of patient involvement and peer support into training for patients and practitioner development.
- Consider opportunities for using lay tutors and people with long term conditions in generic roles, and providing generic support, as opposed to operating in condition-specific or departmental ‘silos’.
- Consider what support you might need to provide to those facilitating or providing peer support, such as training in confidentiality and listening skills.