Stuart kickstarts his weight loss journey with ‘Your Health, Your Way’

When Broxtowe resident Stuart went to his GP and asked for help with weight management, he had tried everything and was desperate for some support to help him drop the pounds.

After listening to his story, Stuart’s GP recommended Nottinghamshire support service ‘Your Health, Your Way’, and completed a referral on his behalf.

Your Health, Your Way (YHYW) is a free service available to support residents of Nottinghamshire to lose weight, get more active, eat healthier, drink less and quit smoking.

Stuart says: “I was contacted two days after seeing the GP and booked onto a telephone appointment. I was a bit nervous as I wasn’t sure what the service involved, but my Healthy Lifestyle Advisor (HLA) Darren made me feel reassured about the service and confident on embarking on this journey. He talked me through all the different interventions that were available i.e Zoom, phone etc. I opted for telephone support.

“I had tried to lose weight in the past but nothing ever seemed to work for me. I tried Weight Watchers, Slimming World and just eating smaller portions, but just couldn’t keep it up for a long period of time. This time, with YHYW, I have lost 8lbs and found all the nutritional information well explained so I could fully understand, as I can easily get confused!’

Stuart is doing his intervention over the phone and receives nutritional resources via email. He loves the portion size module and really likes the fact he was asked to create food diaries and send meal photos to get more specified advice.

“Darren has been doing my 1:1 nutrition and has been brilliant. He explains everything to make it as simple as possible. All information is relatable to my weight loss goal and I feel like I would have struggled if it wasn’t for that regular support. He sends information after every session and is always available for a chat when I need him or if I have any extra questions or queries.

“Losing the weight has made me feel a lot more confident and I’m a lot more mobile than I was before. I find reading food labels interesting and now I always looks at things to see what stuff it contains. Seeing these results in nine weeks has motivated me to continue with the healthy lifestyle.”

Stuart is also now receiving ‘Stop Smoking’ support from YHYW and hasn’t had cigarette since July thanks to his advisor Karen and the nasal spray and patches she prescribed.

“All in all, I would 100% recommend Your Health Your Way!”

NOTTINGHAM AND NOTTINGHAMSHIRE ICS SEEKING NEW CHAIR

Nottingham and Nottinghamshire Integrated Care System (ICS) is seeking a new chair following the announcement that David Pearson CBE will step down from the role when his current contract comes to an end next March.

In 2016, David was asked to lead the development of an STP, which later became the ICS, for health and social care services in Nottingham and Nottinghamshire.

In 2019, the prominent ICS appointed David as its chair in March 2019, and he has played a pivotal role in driving forward transformation and partnerships across health and care in the county.

The ICS will now start a rigorous and robust recruitment process to appoint a new chair of the ICS from March 2021.

Andy Haynes, ICS Lead for Nottinghamshire, said: “David Pearson CBE has decided that he will not be continuing his tenure as chair of the ICS when his contract comes to its planned end in March 2021.

“David’s departure comes after 39 years serving the people of Nottingham and Nottinghamshire where he has played a key role in progressing change and collaboration across health and care in the county.

“We are very grateful for his years of dedicated service and we wish him all the best for the future. The ICS will commence the recruitment process for a replacement chair imminently.”

David worked for Nottinghamshire County Council for 36 years and became the Director of the former Social Services department, with responsibility for adults and children, in 2005.

In 2006, following a change in legislation, he became Corporate Director for Adult Social Care and Health.

With a career full of examples of leading joint working with health and social care, David has collected numerous awards. In 2014 the county’s Better Care Fund plan became one of only five national exemplar plans to have its application fast-tracked by the Department of Health, with the Council being the only two tier authority to achieve this status. At the height of the Covid-19 pandemic, David was also appointed as the Chair of the National Covid-19 Social Care Support Taskforce which includes representatives from PHE, CQC, Care Providers Alliance LGA, ADASS, Healthwatch England, MHCLG, Cabinet Office and DHSC.

David Pearson CBE added: “I have been privileged to lead the Integrated Care System as an Executive Lead and as an Independent Chair.

“Nottingham and Nottinghamshire has been recognised as one of the most advanced health and care systems in the country with many leading examples of innovative services.

“With continued commitment and determination to improve the populations’ health and well-being, I am confident that the city and county will continue to make progress.”

For more information on the role and how to apply can be found at: www.IndependentChairNottsICS.co.uk

Local GP invites South Notts residents to discuss health and care priorities at partnership’s ‘Community Voices’ event

Dr Nicole Atkinson, Clinical Lead for South Nottinghamshire Integrated Care Partnership (ICP) covering Broxtowe, Gedling, Hucknall and Rushcliffe, is inviting people who live in those areas to join her at a digital event to discuss priorities for health and care in the area.

The event, which will take place on Zoom between 3pm and 5pm on Thursday 1 October, will be led by Dr Atkinson, who also works as a GP in Eastwood

The South Nottinghamshire ICP works across health and care organisations, local councils and communities to support the integration of services and help local people live happier, healthier lives.

Interested residents and health and care workers in the area can sign up at: https://south-notts-icp-community-voices.eventbrite.co.uk

Alongside Dr Atkinson, there will be a presentation from Dr Tim Heywood, Broxtowe GP and Clinical Director of Nottingham West Primary Care Network.

People attending the event will be asked for their views on the Partnership’s key priorities for the next year, which are:

Ageing well
Care navigation (the patient journey through health and social care)
Mental health
Health and wellbeing
Community engagement

Dr Atkinson says: “This event is a fantastic opportunity to get involved with the development of integrated services in South Nottinghamshire. I’m really excited to talk about our priorities with local residents and start involving them in our work.

“There has already been a lot of really innovative work that has started here in South Nottinghamshire that has improved services for patients, which has then gone on to be rolled out across other areas. We want to build on those successes and involve local communities to help drive further innovation.

“We really want to engage people so they are genuinely involved in how their local services develop and how we join up care. So, if you have the time and you want to get involved, I look forward to talking to you.”

People who are interested in finding out more about the Partnership and getting involved with shaping services can sign up at: https://south-notts-icp-community-voices.eventbrite.co.uk

Zoom instructions

Event agenda

Community Voices breakout rooms

People who are interested in finding out more about the Partnership and getting involved with shaping services can sign up here.

Population health management. Outcomes: One small word – so many meanings!

Maria Principe, Nottinghamshire Integrated Care System population health management programme director.

This is the first of a number of blogs where I’ll be sharing the Nottingham and Nottinghamshire Integrated Care System (ICS) experience of delivering our six step population health management process. This time, I’m looking at step 1 – Outcomes.

I’m often asked what some of the biggest challenges are when delivering population health management (PHM). Apart from the obvious – analytical capacity, information governance and conflicting policies – I have to say that one of the biggest headaches I’ve come across has to be outcomes!

l learned early on in our PHM journey that in order to segment and stratify the population, we need to have a clear and collective agreement on the outcomes we are trying to deliver. ‘Simples’, I hear you say… Hmmm, maybe not…

When we are looking at delivering a population approach and inviting all sectors to the table, with those partners come their own organisational priorities and interpretations of what an outcome is – and, more importantly, what their boards have signed up to!

In principle, analytical modelling is the easy part. (Sorry analysts, I’m sure you will probably disagree with me.) The difficult part is getting a system of independent entities (which are nonetheless co-dependent on one another) signed up to not only being in the same outcomes boat, but also rowing in the same direction.

This requires compromise, trust and sometimes even a little faith. So, have we got it sussed in Nottingham? No, of course not; it’s a massive task and I’m not sure any system can categorically say that all their participating organisations are signed up to using the same outcome objectives and principles. For your own sanity, don’t try to boil the ocean! (I’ve worn the scars on this one).

Get on the same page

My first piece of wisdom (if you can call it that) to make your life easier would be to ensure that organisations across your system share the same understanding of what an outcome is. Everybody talks about outcomes, and the world and its mother talks about delivering improved outcomes, but when you get down to the nitty gritty and ask “what do you mean by outcomes” you will see that the word and its meaning get interchanged between outcomes, performance metrics, interventions and enablers.

‘Health’ has a beautiful outcomes framework; it’s comprehensive, clear and says the right thing. But the challenge is that this framework does just belong to ‘health’ and it doesn’t necessarily pick up local authority priorities. Some also argue that it has an undercurrent of performance metrics. So, a priority in this step of PHM is ensuring you have a shared understanding of what ‘outcomes’ means to your group.

I would suggest using a test area first. Get clinical, transformational and analytical experts to create joint outcomes for a specific area; this aligns your outcomes bottom up and makes them meaningful. We did this with diabetes (click here to find out more). It may be that once you begin these discussions you find that you are all on the same page (let me know if this is the case; I’ll go looking for the gold plated, singing unicorns). Or, like us, you might soon realise that you have different objectives that complement each other, but require different data and sometimes a different approach. This is when the compromise begins, but getting this section right is the key to your success and is where we gained our valuable final lesson in this section.

Hold your nerve!

I cannot tell you how many times when we start to do a PHM review and discuss outcomes, the discussion goes straight to what interventions we want to deliver, or gets hung up on the variation in “must dos” (although, to be fair, these are often nationally dictated).

Try not to let that shape your outcomes conversation. Holding your nerve will enable you to have really important conversations with partners to understand what is important to them and their view of what’s important for their population. Then you can have the discussion on what is an outcome and what is an enabler. In the world of PHM that technicality doesn’t really matter; what matters is that we are clear about what we are trying to deliver, and that everyone shares that view.

Who we deliver it for is the next step. Second blog to follow soon.

Blog 11- Investing in NHS people- You Matter

Dr Sonali Kinra is our ICS lead for GP Retention. This is her monthly blog series where she gives an insight into her role and more.

It was meant to be summer holidays yet it has been very different this year. While we had really hot days which were welcomed by some, the relentless nature of the pandemic, the continuous cycle of bureaucracy & change while still trying to keep the ship steady balancing kids, home and work has been exhausting.
Nobody has it all sorted and please reach out to friends, colleagues and us for help and support.

There has been welcoming announcement around the much awaited New to practice Fellowship scheme for GPs and GP Nurses. The scheme is nationally funded two years of support, networking, PCN Portfolio working and structured learning opportunities that builds contextual confidence in newly qualified GPs and nurses working in general practice. Phoenix programme(PP) and Nottinghamshire Alliance of Training hub(NATH) have been providing ongoing support to trainees and newly qualified GPs and GPNs. Funding covers reimbursement of one session per week to the employer (pro rata) and provision of learning There is sufficient funding available for all newly qualified GPs and nurses to benefit from the scheme. There is national funding and further information released for Supporting Mentors Scheme and we are soon to hear more about Locum support scheme. Please ensure you are registered with PP and NATH to receive further information.

We have also launched fully funded GP Nurse leadership CARE programme which will be led by NATH in collaboration with National Association of Primary Care. The programme is for 20 nurses, ideally 1 across each PCNs, who would like to lead impactful quality improvement projects, power up multi-disciplinary working and improve their own resilience, confidence and leadership skills by participating in the programme. There are additional 5 spaces which we have made available for Community nursing and Care home nurses to further enhance collaborative working. It is a 6 month programme and includes leadership skills development for the nurse(4 webinars 2 hours each), Population health management project work (4 webinars 2 hours each) and action learning sets(facilitated by ICP lead nurse) with full support, mentoring and supervision. Nurses will be required to implement a service improvement project within their PCN. This is an exciting opportunity- please get in touch with Nicola.payne8@nhs.net for further information

I chaired the Primary care workforce group meeting on 30 July and received updates from various stakeholders. 4 GPs have now started within their PCN portfolio roles- with portfolio roles including care homes,mental health. With further funding and the evaluation from these roles will help us extend this programme to other GPs and GPNs.
Additional roles within PCN continue to be embedded and have been a vital part of the workforce during Covid pandemic despite being new in their roles. A recurrent theme has been concerns raised around mentoring and supervision for these roles as well as leadership opportunities and we continue to work towards this. There is emerging roles cabinet which has been set up but not very active- watch this space- in the interim please feel free to contact me. There is Recovery cell that has been set up across the system which has the responsibility Recovery and Restoration – Joe Lunn and Dr Richard Stratton bringing the primary care perspective. We are in the process of linking up to ensure dialogue.

There have been multiple updates received over the last month from various regulatory and statutory bodies. It can be overwhelming to read these thru- There is an easy to read summary produced by NHS employer’s on NHS People plan, third phase NHS response to Covid -19 letter where the take home message for me was “General practice, community and optometry services should restore activity to usual levels where clinically appropriate, and reach out proactively to clinically vulnerable patients as well as emphasis on winter planning with extended flu immunisation and extended 111 offer and Updated SOP(standard operating procedure) for General practice

Deadline extended to 24th August for expression of interest for NHSE Sentinel programme on Video Group consultations. I have conducted one for my Fibromyalgia/Chronic pain patient registered with my surgery alongside Rheumatologist and received great feedback from the patient.
We have also submitted expression of interest for Midlands Trailblazers fellowship which is being offered in conjunction with HEE Yorkshire and Humber who have been running these very successfully for some time. There is a new Deepend GP group set up in Nottingham- if interested please email helen.davies15@nhs.net– further information and podcasts here

I also recorded an interview with Dr Anthony James on top tips for CV and interviewing – as part of CelebrAiT series– festival to prepare GP trainees for a successful career ahead.
I have been supporting trainees in discussion with HEE discussing regarding structural barriers and racism and what needs to change as well exploring the learning needs around differential attainment unconscious bias and breaking down barriers. I would like to hear from you how we improve things.

We have set up Primary care Racial Equity and Diversity Working group and now submitted proposal to Notts ICS People and Culture board for supporting this group for You- Our Primary care workforce. We will be advertising further for electing lead for this Working Group. There are many who have volunteered their time in setting this up and I remain grateful to them and in giving this structure and vision.
We are holding 1st Nottingham and Nottinghamshire Racial Equality, Diversity and Inclusion Symposium on 2nd September 3pm-4:45pm on virtual platform. Chief people Office Prerana Isaar and newly appointed chair for NHS Health and race Observatory Marie Gabriel have agreed to join and we all want to hear from you- what has worked for you and what hasn’t- what barrier are you facing in your career progression and what can we(as system leaders and individuals)do better. Please register your interest with j.redshaw@nhs.net

And now a personal plug- I am standing for RCGP council election- voting now open 21st August- 11th September. I am standing for Accountability, Transparency and Engagement and hope that these blogs and my interaction with you has demonstrates these values I stand for. Please vote
As always open to feedback.

Sonali
@SonaliKinra

Primary Care Networks – a year in review by Jonathan Harte, Clinical Director, BACHS Primary Care Network

Following the publication of the Long-Term Plan NHS England provided a framework for Primary Care Networks (PCNs), local networks of GP practices and other primary care services (such as community, mental health, social care, pharmacy, hospital and voluntary services), who work together for their local population and are defined by local geography or neighbourhood.

In Nottingham city we have eight PCN’s that were formed in July 2019. Our PCN practices work together under the leadership of a Clinical Director (like me) to improve patient access to services, and the wider health and care system. So, as we celebrate the end of our first year, I wanted to take a moment to reflect on the transformation that is underway.

Additional capacity
Healthcare is renowned for struggling to keep up with demand for appointments. And, in Nottingham city we are no different. However, by listening to the feedback of our patients, and working together locally, we are making changes that enable more proactive, personalised, and coordinated care.

Our Clinical Directors and Deputy Clinical Directors are working in each PCN to create locally focused strategic plans. Resulting in local services that reflect the needs of their local populations’ specific health and care needs. Notably this year we have employed 13 Social Prescribing Link Workers, 22 Clinical Pharmacists and 7 First Contact Practitioners who have enabled patients to be seen more appropriately for their needs releasing GP appointment time to manage other complex cases.

We are also consistently delivering an additional 195 hours (approximately) of GP appointment time per week through ‘Extended Hours’ out in PCN neighbourhoods and the Extended Access GP+ service at Upper Parliament Street.

Quality Improvement
This year we have begun a number of improvement works including, but not limited to:
Prescribing safely and safe use of medicines with shared learning to reduce harm though PCNs and Clinical Pharmacists
Safer use of NSAIDs – reduce complications (GI bleed)
Lithium Prescribing – better monitoring systems
Valproate and pregnancy prevention – engaging patients

Improving involvement of carers in end of life care and ensuring a coordinated care response to work better with palliative teams and carers and care homes
Better identification of people in the last year of life
Involvement, support and care for those important to the dying person
Coordinated care, responsive to patient’s changing needs
Covid
Still in their infancy our PCNs are evolving and developing. Therefore, having a global pandemic occur six months into their first year of formation has been both a blessing and a curse.

Our collective PCN response to Covid has been excellent. There has been considerable work undertaken by PCNs, the GP Alliance and the CCG’s locality team to set up Clinical Management Centres (CMCs) for the city. Allowing those patients with Covid symptoms to be safely seen by a doctor, while minimising risk to the health of the general population. The two CMCs, at Bulwell and St Anns, were staffed with support from the PCN teams, practice staff and the city locality team. We now have one CMC in operation at Nottingham City GP Alliance, Angel Row Entrance, that will take us through the coming winter period.

During the peak of the pandemic Nottingham City GP Alliance also ran a home visiting service for people too unwell to travel. This was a real success enabling people with suspected Covid symptoms to be seen in the community, reducing demand on other services.

The Social Prescribing Link Workers workforce recruited by PCNs have been supporting patients who were shielding with vital contact and support. Involving other agencies, as and when required, to safeguard our local population.

The team of Clinical Pharmacists are supporting practices with medication management processes such as electronic repeat dispensing, and remote medication reviews.

There is no escaping that Covid has likely changed general practice and our ways of working forever. And it has shown what is possible when organisations across all sectors pull together around a shared goal.

Restoration and recovery
As restoration and recovery of primary care occurs PCNs will look to embed collaborative working into their plans, making connections across all health and care partners and bringing on board more community colleagues.

Some PCNs are looking at creating a Deep End Project group to support and improve care in the most deprived parts of the city.

The next 12 months will also see a focus on service specifications for enhanced support to Care Homes, improving early cancer diagnosis and improving support to those with Learning Disabilities linking to the Nottingham City ICP Priorities.

Integrated working in Hucknall provides support for Gordon in a flash!

When Gordon was taken to A&E twice in July due to issues with his heart, on both occasions he refused admission, keen to return to his wife for whom he is the main carer.

But it was clear after his visits to A&E that Gordon needed some support to stay safe and well in his home and ensure he could continue caring for his beloved wife.

The community matron and local nursing team advised that Gordon needed social care support, so Hucknall Care Co-ordinator Emma Footitt referred him to Suellen Harriman, community care officer, with Ashfield South and Hucknall Ageing Well Team, which is part of the Nottinghamshire County Council’s Adult Social Care service.

Suellen immediately contacted Gordon, who had previously been independent and was unknown to social care, to complete an assessment. After he explained his difficulties with his mobility, managing his personal care and medications, Suellen referred Gordon to the Council’s Start Reablement, a team which could support him with occupational therapy and maximising independence through care and support.

The Start team accepted Gordon’s case on 29 July 2020 and started providing support the following day.

The speed with which Gordon’s situation was handled is testimony to how far integrated working in Hucknall has developed. Teams are now working far more closely together, enabling them to respond quickly in the interests of the patient.

Gordon says: “It’s been very fast, getting me the help that I need.”

Gordon’s daughter, Tracy Eden, adds: “It’s really good how it’s all come about so quick. I’m hoping it’s going to give me support and give Dad the help he needs.”

Prior to the Covid-19 pandemic, teams of health and social care workers had been co-located at Hucknall Health Centre since September 2019, which gave them the chance to work together and put patients at the centre of everything.

This more efficient way of working has set a high standard for integrated working.

While Covid has now prevented the teams from being physically co-located, they’ve continued to work together and hold regular multi-agency meetings online to discuss individual patient’s needs.

Gordon has undoubtedly been a beneficiary of this improved multi-agency co-operation.

Steve Jennings-Hough, Transformation Manager, Adult Social Care and Public Health at Nottinghamshire County Council, says: “Our integrated teams work extremely hard to support people to be discharged from hospital as soon as they are well, and help people avoid hospital admissions, ensuring they are supported at home with the appropriate level of care and support.

“We have incredibly committed staff working collaboratively across primary, community and social care teams and everyone involved in care planning strives to work together and do their best by their patients. The benefits of working closely together provide the best possible outcomes for patients.”

Integrated working supports Broxtowe care homes through Covid-19

The Covid-19 pandemic has not only highlighted the incredibly valuable role of health and social care, but also the need for organisations and communities across local areas to work together to protect and care for the vulnerable.

Care homes have been particularly affected by the pandemic, but a local joint response from Nottingham West Primary Care Network (PCN) and the Primary Integrated Community Services (PICS) team has yielded positive results.

Earlier this year, Nottingham West PCN commissioned PICS to look at Recommended Summary Plan for Emergency Care and Treatment (ReSPECT), initially focussing on local care homes across nursing, residential, learning difficulty and mental health settings.

The project was led by Jessica Waterhouse and Wendy Berridge, team leaders in the PICS Advanced Planning Team and both experienced Palliative Care Nurses.

Not long after the project had started, Covid-19 changed everything and Jessica and Wendy immediately recognised the challenges that care homes were facing.

All 33 care homes in Nottingham West were short-staffed, in some instances having 70% absence rates as a result of sickness, isolating or shielding. Managers were overwhelmed, often having to step in to care for residents while also managing all the data and guidance coming in. All the staff were having to learn new skills because visits by community nurses and GPs were reduced in order to shield the residents.

Wendy and Jess jumped into action, mobilising partners across the PCN and inspiring and encouraging the GP practices, Community Services and care home staff to come together to care for the patients, clinicians and communities within care homes.

They have worked tirelessly, assisting with training, resolving practical issues around PPE, new equipment and remote technology skills, helping with patient care and providing psychological support for staff, patients and their families.

They have also set up a Whatsapp group that any care home colleague could join, and sent out daily updates and bulletins to try and help make sense of the storm of legislation, guidance and changes that care home staff had to understand, implement and respond to. There are currently 49 members of the group – all care home management staff.

Wendy and Jess contacted care home staff daily and sent them cards and positive messages of support as morale was low and staff often felt disconnected. They also managed an appeal for donations of toiletries, and these helped residents feel connected to the outside and reassured them that they hadn’t been forgotten. They also helped tide them over until they could get their own again.

Kate Prince, Home Manager at The Herons Care Home, said: “On behalf of my team, I cannot praise Wendy and Jess enough for their support during what was the most challenging time for all care homes, including us.

“They rang three times a week, more if they felt we were struggling, and set up an amazing Whatsapp group for all the Care Homes in our area. I honestly don’t know what we would have done without them.

“They became our virtual friends, and I could ask them literally any question, no matter how daft it seemed. They were the voice of reason and calm and I thank them from the bottom of my heart. They really are amazing people.”

PICS Managing Director Alison Rounce said: “It’s made such a difference, just when the community needed it. As a non-clinician supporting clinical services, I could not feel more proud of how this has supported our care home heroes.”

In early June, all the care homes were COVID-free and staffing levels had returned to normal, but many of the changes and improvements will continue, particularly the development of the network of colleagues working in or managing care homes, which has continued to be a source of support and information for care home managers and senior staff.

Social prescribing – spotlight on the Rushcliffe team

A look at how social prescribing has developed across Rushcliffe before, and throughout, Covid-19…

Social prescribing – spotlight on Rushcliffe

Social prescribing is a relatively new service, which designed to help people address their physical and mental health and general well-being by connecting them to support within the community.

GPs and medical practitioners will refer patients to their local social prescribing team, after which they will have an appointment with a social prescriber who will support patients to identify the improvements they want to make.

Social prescribers listen and put people in touch with the groups and activities that might make them feel better. A social prescribing link worker could connect someone to a community group, a new activity or a local club, or they might help access legal advice or debt counselling. They might just help find information and guidance by using a bit of inside knowledge on individual situations or what local resources there are.

Rushcliffe Social Prescriber, Gwynneth Owen, says: “We always say it’s the kind of support that doesn’t come in a tablet or a bottle of pills, but what we do provide hopefully complements clinical interventions. It’s a holistic approach that really gives patients the confidence to have more control over their health and well-being.

“We help people achieve their goals, whether it’s losing weight, taking more exercise, managing their anxiety or getting information about benefits.”

The Rushcliffe team, which is managed by PartnersHealth, base their approach on the five ways to wellbeing. This is an evidence based model that can improve your physical and emotional health.

The approach covers:

Signposting to local resources
Health coaching
One-to-one support

GP and South Nottinghamshire ICP Clinical Lead Dr Nicole Atkinson says: “Social prescribing has proven to be invaluable in helping us care for some of the most vulnerable people in our communities, while also freeing up our time GP’s time to manage more complex or urgent cases.

“While Covid has created new challenges for our social prescribers, the service is very agile and has responded quickly to changes in ways of working to continue to provide support, and in many cases a vital lifeline, keeping people connected to services.”

Download the new Social prescribing leaflet