Integrated Plus supports people aged 16 and over who frequently visit their GP and who are at high risk of hospital admission. The aim of the service is to look at the whole needs of a person, regardless of what those needs might be and jointly find solutions to problems faced. Integrated Plus is a social prescribing service and we help identify opportunities for people to become more involved and active in their community to help improve their wellbeing. We also help to ensure people are accessing services and activities appropriate to their needs.
Integrated Plus is delivered by 1 manager, 5 Locality Link Officers, 5 Link Support Workers and 1 administrator.
Locality Link Officers attend the 46 multi-disciplinary team meetings in their locality (held at GP practices) to ensure the non-medical needs of people are being met.
Integrated Plus staff undertake social prescribing, however, the roles are not about just brokering people into services, the support is much more tailored and in-depth when people are in crisis, are waiting to access services and who have an urgent need.
IP intervention types
The following provides examples of some of the intervention types provided by the Integrated Plus team:
Accessing services on offer
- We help people access work programmes and ESOL classes.
- We ensure people are getting the benefits they are entitled to.
- We support people with navigating the health and social care system.
- We connect people into services and activities that can help with all kinds of issues eg mental health, drug and alcohol addiction etc.
- We ensure people are getting the right care and support they need and are entitled to.
- We help people apply for Personal Independent Payments and Attendance Allowance.
- We accompany people to benefit tribunals if there confidence is low (this doesn’t involve acting as a representative for them during the tribunal meeting).
- We help people access disabled bus passes and connect people to transport services such as Ring and Ride.
- We issue emergency one-day travel passes when people are in crisis and have no money to attend benefit appeals appointments.
- We accompany people to services/activities up to a maximum of three times if their confidence is low.
Building a home
- We ensure people have adequate heating and food by issuing food bank vouchers and signposting people to Public Health Winter Warmth scheme.
- We help to resolve housing issues.
- We help people access white goods voucher’s.
- We help people to live as independently as possible in their own homes by helping to arrange home adaptations, telecare etc.
Connecting and supporting people
- We connect people into a wide range of social, leisure and faith based activities.
- We support people with family issues.
- We help people reconnect with friends or family.
- We connect people with each other to offer peer support.
- We connect people to peer-led networks and groups.
- We support people to run peer and social activities themselves.
Integrated Plus is funded by Dudley CCG.