As a social prescribing link worker based in primary care for the past five years, Mark Adley now divides his time between social prescribing and research. Here he discusses his recent involvement in the SHARP (Spiritual Health Awareness and Recommendations in Primary care) study at Newcastle University. The SHARP project is led by GP Dr Orla Whitehead who has been working in this subject area for several years - Mark joined as a research associate for the final year of the project.
What attracted you to this study?
Well, at first I was both attracted to it and also a bit hesitant - a lot of this was to do with language, and how the term ‘spiritual health’ was being used. I was drawn to the study because much of my work as a social prescriber involves supporting patients to find a sense of purpose and connection, and for me spiritual health is an important part of people’s health and ‘what matters to’ them. At the same time, I was worried about how the topic of spiritual health would fit into primary care, whether this was going to put more pressure on GPs, and whether the study was something to do with organised religion. I wasn’t alone with these actually, and as the study went on I learned that many people taking part had similar thoughts.
So, what do you mean by spiritual health?
I think the first thing is that for many people, spiritual health is not linked to religion but is more to do with their wellness, their sense of connection, balance, or purpose. I find my spiritual connection hiking out on the moors in Northumberland, for example. However, for some people their spiritual health is part of their faith and religion. So – the language around this topic can be tricky at times, as it’s a very personal thing. At some level though, spiritual health is whatever it means to you.
How does spiritual health fit into primary care?
Although there’s research that shows how important spiritual health is to overall health, there is still a sense that spiritual health is a sensitive or taboo topic that shouldn’t be discussed in primary care. This may well mean that people who would benefit from support with their spiritual health are not having these needs met. GPs and Social Prescribers that were interviewed felt that training was the way forward, and this leg of the SHARP study has focused on designing a short, practical training course around spiritual health for primary care staff.
How does spiritual health fit into social prescribing?
We interviewed social prescribers about this and they broadly fell into two groups. One group felt that spiritual health was linked to religion and that we shouldn’t be discussing this with patients unless they brought it up. The other group felt that we already address spiritual health within what matters to you, and that patients’ wellbeing, hope, purpose and connection are – as one link worker said – ‘at the core of what we do’.
Speaking personally, our social prescribing team in Wallsend have helped many people to rediscover their sense of connection and purpose by getting back into walking or gardening for example. I will also never forget a home visit with a patient whose husband had recently died, she was drinking heavily and becoming increasingly isolated and low in mood. It was one of those long conversations that seemed to have no light until I asked whether she had a faith. Her face lit up – this was clearly something very important to her. It also meant that we had something that we could anchor our future conversations around.
What’s next for the project?
The short training course for practice teams is planned to be launched this year on the BMJ Learning platform, which means that GPs and clinicians can get CPD points for completing it. We’ve worked closely with GPs, practice managers, social prescribers, parish nurses, chaplains, and patients with lived experience to make sure that the course content is grounded and realistic. As some practitioners had asked for guidance around how to bring up the topic of spiritual health with patients the training introduces the HOPE toolbox. This a flexible approach that encourages a gentle, open conversation about a person’s Hope, Organised religion, Personal spirituality and practices, and the Effects these have on their care. Our own hope is that the training will give practitioners the confidence to explore patients’ spiritual health, and help to normalise conversations about spiritual health within primary care.
Four open-access (£0) papers from the SHARP study are now available:
What is ‘Spiritual Health’? A Survey of Social Prescribers in the United Kingdom
Discussing spiritual health in primary care and the HOPE tool - a survey of social prescribers
NASP have also announced the launch of a two-year project that will explore and strengthen the contribution of community-based faith organisations to social prescribing across England.
