Wellbeing Scripts Insights

In our work we are exploring the concept of a ‘Wellbeing Script’ and what it might be, how it might work, and most importantly, how it can simplify and ease a referral pathway between clinicians, their patients, and their local Neighbourhood House- those powerhouses of social connection. This opens a world of possibility largely revolved around a referral model bringing patients from disconnection to social connection with positive health impacts. We have discovered many gems and ‘natural social prescribers’ already in our project in the Central Highlands region of Victoria. They are the forward thinkers in General Practice and medicine who seamlessly practice prevention, as much as preventative and primary care in their daily consultations.

One such gem is Dr Kevin Lee, an endocrinologist and specialist physician who fell in love with Clunes many years ago and continues to practice in this vibrant little community. Dr Lee champions the importance of social and community connection and refers patients in his consultations to a range of health promoting activities not as an extra but a fully integrated part of clinical practice.

Dr. Lee believes it is “simple and day to day practice, you don’t need an extra session just to socially prescribe”. Dr. Lee can share many stories of light social prescribing benefitting his patients. One such patients he recalls presented with obesity (BMI of 37), prediabetes, rheumatoid arthritis, and was wheelchair bound. Dr. Lee noticed that they had an interest in gardening in their backyard.  After engaging them with the benefits of horticultural therapy, he had essentially ‘prescribed’ them a course of increased gardening activity which not only increased their dietary fiber intake from their own produce, but over time, they “no longer needed a cane to walk, reversed [their] prediabetes to normal and [could] drive to go back to work [again]”. Her husband was also able to demonstrate his support for her by building raised vegetable boxes and platforms to garden on.  In just over six months, they achieved more than 15% weight loss, from 106.9kg to 89.4kg, which is equivalent to a gastric band intervention.

Dr. Lee and Lana de Kort, Clunes Neighbourhood House Manager, have teamed up to imagine what is possible in their community. As a start they have designed and are at present delivering and intensive lifestyle modification program “Weight off my shoulders” with their community. The first program was full upon announcement, we look forward to hearing about the health and wellbeing impact in the future.

Sometimes it is nice to know we can just get on with it – try things, iterate, try again. We don’t need to wait for the perfect system for social prescribing, we can lightly prescribe right now- with the resources available in communities across Victoria, and certainly sign-post pathways for health and wellbeing.

“I have had a few patients that you try and do the right thing by them to support them in the clinic, but you realise that they actually need social groups to help support them long term as well” – a contributing GP

Overt the past couple of months we have been reaching out to some of the amazing doctors, specialists and community leaders across our region to explore their passions, ideas and concerns about implementing a Wellbeing Scripts System, creating pathways between doctors and neighbourhood houses to support social connection and wellbeing. We are thrilled to be able to share some of the insights we have gathered from these interviews.

Short story – there is tremendous potential to be unlocked.

“One of the most exciting and rewarding moments in a project like Wellbeing Scripts is when a GP learns about a House and the breadth and depth of health promotion, social connection, learning and training initiatives that are available, and the preventative possibilities for their patients – it’s like a new door has been opened”

Dr Shelley Bowen, Health Futures Australia, www.healthfutures.org.au

WSSB draws on a social innovation approach deeply rooted in Human Centred Design – we are starting with an agile, people first focus, to strengthen and connect existing community and health resources.

Sometimes projects that need to build new systems can fall under the weight of their complexity- being overwhelmed by the amount of resources and change that is needed for something new. For this project our purpose is clear and different – the “Wellbeing Script” adopts a social innovation approach.

This means we deeply engage, learn, prototype, test and improve a localised ‘light’ referral pathway between doctors and Neighbourhood Houses. The users of the Wellbeing Script are best placed to design what works. Our first step of deep engagement and insight gathering is undertaking a wide range of ‘dialogue interviews’ with doctors, medical practices, and Neighbourhood Houses leaders. Then focussing on communities across the region, we look at the interview data, and further evidence, and start to develop and test ideas, constantly adapting and improving until it works for doctors and Neighbourhood Houses in their community.

Wellbeing Scripts System Building (WSSB) is inspired by Social Prescription – the U.K. model providing real insights into the effectiveness and power of community in strengthening health and wellbeing. In 2020 we conducted a review of academic papers and collected together key findings to explore how we might draw on this amazing work to create healthier pathways in Australia.

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Imagine if we could reduce the pressure on health services by 20%, whilst increasing the resilience and health of people in our communities, creating better places to live.

The evidence is in – it is possible. By creating stronger links and pathways between health practitioners and community we improve our framework for wellbeing, supporting medical interventions as well as social connection- both essential in wellness. Our approach draws on the fundamentals of Social Prescription – people, opportunity and trust, to build a fit-for-purpose Australian model from the ground up.

‘Social Prescription’ is a system where doctors can refer people to community activities, reducing the strain on the medical system and improving medical results for people. Developed in the U.K., Social Prescription started out as a simple place-based approach to health- connecting people through community, to support health and wellbeing. Over the past three decades it has become a complex and internationally recognised system with real and meaningful success.

In early 2020 CHANH met with Health Futures Australia and the Ballarat Subdivision of the Australian Medical Association to develop the concept of Wellbeing Scripts – our ‘take’ on Social Prescription, or, how we might develop Social Prescription in a regional, Australian setting.

In June 2020 we were successfully funded by the Australian Government to begin prototyping and raising awareness of the value of social connection for wellbeing.