Our inaugural project is to come to an end after 10 years’ success
Long-term conditions are a major driver of NHS costs, estimated to exceed £115bn each year, a figure reflecting the complexity of care needed by those with chronic conditions including asthma, Chronic Obstructive Pulmonary Disease (COPD), diabetes, arthritis, epilepsy, osteoporosis, high blood pressure, and heart disease.
With this in mind, Ways to Wellness is sad to confirm that the project that led to our founding is to come to an end this summer, having supported more than 11,000 client journeys over the last 10 years.
A bit of background
Ways to Wellness began life in 2015 with the launch of our Long-term Conditions service – a world first in using outcome-based funding from a Social Impact Bond to pilot a new way of working in Social Prescribing.
Initially focused only in the west of Newcastle, where deprivation was higher and life expectancy lower than the average in England, the cross-sector collaboration involved partners across multiple organisations, with Ways to Wellness centrally positioned as a special purpose facilitator, holding contracts with the investor, public sector commissioners, and delivery organisations from across the Voluntary, Community and Social Enterprise (VCSE) sector.
In its catchment area, this pioneering service supported those aged between 40 and 74 with one or more of the specifically diagnosed conditions, including those listed above.
The pilot tested a social prescribing model based on the fundamental relationship between social prescribing link workers and their clients, delivered consistently over time, with outcomes measured using Triangle’s Wellbeing Star – a quantitative, visual tool that gives clients a whole-life view of the situation they find themselves in, helping them identify where they can make positive and lasting change in a way that is meaningful to them.
We gathered evidence throughout the pilot, which in its first six years achieved the following outcomes:
Reduced activity and costs of payment-by-results secondary care for the 14,000 patients in the initial cohort.
This equates to around £120 per capita, i.e. £1.68 million a year in relative cost savings compared to the control group. This was largely created by variance in non-elective admission rates of the two groups.
A statistically significant reduction in HbA1c – a widely-used measure of blood sugar levels – for the sub-group of individuals with a diagnosis of diabetes of pre-diabetes compared to the control group.
A statistically significant increase in the use of medications that control diabetes comparing the intervention and control groups.
A statistically significant reduction in antidepressant use in the cohort compared to the control group.
Very significant improvements in wellbeing for people engaging with our support, using the validated ‘Outcome Star’ tool for long-term conditions.
What we discovered
This positive early data enabled us to increase both the scope and reach of the prototype to those aged 18 to 74 registered with one of 17 GP practices across Newcastle upon Tyne.
We were also able to accommodate self-referrals, and referrals from other VCSE sector organisations to offer even more individuals life-changing, open-ended, long-term support.
For those that may wish to learn more about the project, our evidence is supported by various independent reports, including the recently published Final in-depth review into Ways to Wellness’ original Social Impact Bond by the National Lottery Community Fund, as well as the INDIGO Project case study published by the Government Outcomes Lab, and two diabetes specific academic publications by Moffatt et al, published in 2019 and 2023 respectively.
Because the service targeted specific populations, it has complemented what is now being achieved by the Additional Roles Reimbursement Scheme (ARRS) social prescribers that operate across Primary Care Networks (PCN), and we are immensely proud of all that has been accomplished by our dedicated delivery team.
However, the Long-term Conditions service, which will come to an end on 18 July after the decision was made for its funding to be withdrawn, is now only one of the varied projects we host that are at different stages of development. Our work as a trusted test bed for healthcare innovation very much continues, and all other prototypes, including PROSPeR and our Persistant Physical Symptoms service, are unaffected by this development, with our SPACE Pilot having recently expanded into its third phase of delivery.
Having closed to new referrals earlier this year, our Long-term Conditions team has been working with our many partners to transition individual patients towards an appropriate exit from the service. Our priority over the remaining weeks of its operation is to ensure all clients can be discharged safely and referred to alternative support as appropriate to their needs.
A time for reflection
While we are disappointed that the service will be closing, we are proud that Ways to Wellness was able to fulfil its role by demonstrating that social prescribing can be successfully scaled at a population level while realising cost savings across the wider health and care system, supporting thousands of individuals to better manage their health and wellbeing in doing so.
It is thanks to this service that we have been able to expand our work to support more individuals and families in more and more novel ways, the insight gained from this transformational project having been instrumental in the national rollout of social prescribing.
Across all our projects as they evolve over the coming years, we continue to be evidence-led, so we are able to demonstrate the impact of these interventions, to help the system realise positive, sustainable change that benefits people facing the biggest barriers to achieving and maintaining good health.
