The NHS is a world class healthcare system but, like many modern healthcare systems, it is more of a “sick care” system, responding when people become sick to address symptoms and manage illnesses.
This approach works well for acute illness, but it is not as effective in treating chronic, long-term health conditions. The evidence shows that supporting people to better self-manage their long-term conditions will significantly improve their health outcomes while decreasing their dependency on traditional health services. Ways to Wellness addresses this need through ‘social prescribing’ – the use of non-medical interventions to help people living with long-term conditions to achieve and sustain healthier lifestyle choices and improved self-care.
It is difficult for the NHS or other government departments to fund a service like Ways to Wellness when budgets are already committed to urgent and essential services. Furthermore, given the degree of innovation that Ways to Wellness represents, it is a risk for a public sector commissioner to commit significant funding to a service that may not achieve its ambitions. Ways to Wellness is able to deliver its social prescribing service ‘at scale’ through Social Impact Bond investment of £1.65million from Bridges Ventures – the first of this type of funding to be used to fund a health service in the world. The Social Impact Bond funds are invested in Ways to Wellness at risk – investors are repaid only when agreed outcomes are achieved with a public sector commissioner. Ways to Wellness’ commissioner is Newcastle Gateshead Clinical Commissioning Group (CCG), who have committed to a seven-year contract involving payments for outcomes of up to £7million, with further outcome based funding committed by the Big Lottery Fund (£2million) and the Cabinet Office (£1million). Ways to Wellness is paid for two outcomes: reduction in hospital costs and improvement in patient wellbeing.
I trained and worked as an Occupational Therapist in Canada and England, later working in NHS commissioning. On both a professional and personal level, I immediately recognised the valuable opportunity Ways to Wellness represents and its potential to make a significant difference in the lives of some of the most vulnerable people in our society.
It is exciting to be part of such significant and ground-breaking work, but it is not straightforward or easy. Ways to Wellness is innovative in its intervention approach, funding type and contracting structure. We are learning and adapting as we go and have few precedents to follow or draw from. There are numerous organisations and stakeholders that are directly involved in making Ways to Wellness a success, from our four provider organisations to NHS teams who refer patients to our service. This degree of innovation and complexity requires a high level of communication and collaboration as well as rigorous monitoring and evaluation throughout the delivery process.
The Ways to Wellness service has been in operation for 16 months and the early indicators are very strong – we have had over 1,700 new patients referred to Ways to Wellness and their wellbeing improvements are well above target. We are now entering a phase where we can further analyse and learn from our initial processes and approaches, such that we can start to identify what’s working well and might need to be adapted to optimise outcomes for patients. This is another exciting step along the journey of this pioneering venture.