The team have been working with GP surgeries across Dudley for 7 years. We have well established relationships with each surgery in our localities and with our CCG and local authority services. We are in the fortunate position of being employed by Dudley Council for Voluntary Service (DCVS), which means that we can tap into charities, groups and community activities. When the pandemic hit, DCVS worked with the local authority, the CCG and other health/community partners to develop a support service. This was up and running within two weeks and the Integrated Plus team played a vital role in this. The Integrated Plus team led on weekly virtual meetings with other representatives from health and community services, including colleagues from Public Health, social services, housing, mental health services, domestic abuse charities and more. These meetings have provided a place to discuss complex cases where an individual’s needs could not be met by allocating a volunteer befriender or shopper for example. In addition, they dealt with over 800 referrals within a 3-month period from agencies, in the main GP practices where they efficiently arranged for appropriate support to be put in place for these vulnerable individuals. In addition to our generic Social Prescribing Service, Integrated Plus also has a High Intensity User service that works with the local hospital to support patients who attend hospital/call 999 frequently for non-medical issues. Throughout the pandemic our two Link Workers have continued to run the service, providing telephone support to their patients at all hours to provide them with reassurance and to deter them from visiting the hospital. I have been immensely proud of how hard every member of the team have worked over the past few months to ensure that the needs of local vulnerable people have been met.
