What is social prescribing?

Many things can affect your health and wellbeing. We know that it can take more than medicine to help you get better.

Social Prescribing enables GPs, nurses and other health and care professionals to refer people to a range of local, non-clinical services.

The Sunderland Social Prescribing Service will work with you to find out ‘what matters to you.’ The team will then support you in your own community.

What support can I get?

Many of life’s problems can make you feel unwell. We can help you with a range of things like:

• Loneliness
• Emotional Wellbeing
• Money worries
• Housing worries
• Healthy lifestyle choices
• Managing long-term health conditions

What are the benefits?

• Improve your mental and physical health
• Get involved in your community
• Meet new people
• Increase self-confidence and self-esteem
• Better quality of life

How do I access the service?

Ask your GP to refer you to the Sunderland Social Prescribing Service, or complete the referral form below.

Making a Referral

*Please note all fields are required

Who is making this referral?

Patient

Professional

Link Worker

Self Referral

Full Name

As shown on medical record

Would prefer to be known by / What name do you prefer to be called?  Optional

Date of Birth

Day

Month

Year

Are you homeless?

Yes

No

Address

Street Address Address Line 2 City Postcode

Name of GP registered

Please select..Not registered with a GPAshburn Medical CentreBridgeview Medical GroupCastletown Medical CentreChester Road SurgeryConcord Medical GroupDeerness Park Medical GroupDr Gellia and BalaramanForge Medical PracticeFulwell Medical CentreGalleries Medical PracticeGrangewood SurgeryHappy House SurgeryHerrington Medical GroupHetton Group PracticeHoughton Medical GroupHylton Medical GroupI J HealthcareKepier Medical GroupMillfield Medical GroupMonument Surgeries (Barmston and Galleries)New City Medical PracticeNew Silksworth Medical GroupNew Washington Medical GroupPallion Family PracticePark Lane PracticeRedhouse Medical CentreRickleton SurgeryRiverview SurgerySouth Hylton Medical GroupSouthlands Medical GroupSpringwell Medical GroupSt Bede's Medical CentreThe Broadway Medical GroupThe Stephenson Medical Practice (Dr Stephenson and Partners)Village SurgeryVillette SurgeryWearside Medical PracticeWestbourne Medical Group

Contact number

Email  Optional

Reason for Referral

Please Select..Adult Social Care/ Occupational TherapyCancerCarerDomestic ViolenceEmployment SupportFinancial AdviceFrequent GP AttenderFuel SupportHousingLong Term Condition ManagementMenopauseMental Health IssuesPhysical InactivitySocial IsolationSubstance MisuseWeight Management

Additional Information  Optional

Professional Referral

Name of Professional

Service Name

Telephone of Professional

Email of Professional

Any Identifiable Risks ?

Yes

No

Risks

Full Name of Patient

Patients Date of Birth

Day

Month

Year

Is the Patient Homeless?

Yes

No

Address

Street Address Address Line 2 City Postcode

Name of GP registered

Please select..Not registered with a GPAshburn Medical CentreBridgeview Medical GroupCastletown Medical CentreChester Road SurgeryConcord Medical GroupDeerness Park Medical GroupDr Gellia and BalaramanForge Medical PracticeFulwell Medical CentreGalleries Medical PracticeGrangewood SurgeryHappy House SurgeryHerrington Medical GroupHetton Group PracticeHoughton Medical GroupHylton Medical GroupI J HealthcareKepier Medical GroupMillfield Medical GroupMonument Surgeries (Barmston and Galleries)New City Medical PracticeNew Silksworth Medical GroupNew Washington Medical GroupPallion Family PracticePark Lane PracticeRedhouse Medical CentreRickleton SurgeryRiverview SurgerySouth Hylton Medical GroupSouthlands Medical GroupSpringwell Medical GroupSt Bede's Medical CentreThe Broadway Medical GroupThe Stephenson Medical Practice (Dr Stephenson and Partners)Village SurgeryVillette SurgeryWearside Medical PracticeWestbourne Medical Group

Patients Contact Number

Patients Email  Optional

Reason for Referral

Please Select..Adult Social Care/ Occupational TherapyCancerCarerDomestic ViolenceEmployment SupportFinancial AdviceFrequent GP AttenderFuel SupportHousingLong Term Condition ManagementMenopauseMental Health IssuesPhysical InactivitySocial IsolationSubstance MisuseWeight Management

Additional Information  Optional

Do you have the patients consent to make this referral?

Yes

No

Link worker (Outreach)

Name of Link worker

Event / Outreach venue

Full Name of Patient

Patients Date of Birth

Day

Month

Year

Is the Patient Homeless?

Yes

No

Patients Address

Street Address Address Line 2 City Postcode

Name of GP registered

Please select..Not registered with a GPAshburn Medical CentreBridgeview Medical GroupCastletown Medical CentreChester Road SurgeryConcord Medical GroupDeerness Park Medical GroupDr Gellia and BalaramanForge Medical PracticeFulwell Medical CentreGalleries Medical PracticeGrangewood SurgeryHappy House SurgeryHerrington Medical GroupHetton Group PracticeHoughton Medical GroupHylton Medical GroupI J HealthcareKepier Medical GroupMillfield Medical GroupMonument Surgeries (Barmston and Galleries)New City Medical PracticeNew Silksworth Medical GroupNew Washington Medical GroupPallion Family PracticePark Lane PracticeRedhouse Medical CentreRickleton SurgeryRiverview SurgerySouth Hylton Medical GroupSouthlands Medical GroupSpringwell Medical GroupSt Bede's Medical CentreThe Broadway Medical GroupThe Stephenson Medical Practice (Dr Stephenson and Partners)Village SurgeryVillette SurgeryWearside Medical PracticeWestbourne Medical Group

Patients Contact Number

Patients Email  Optional

Reason for Referral

Please Select..Adult Social Care/ Occupational TherapyCancerCarerDomestic ViolenceEmployment SupportFinancial AdviceFrequent GP AttenderFuel SupportHousingLong Term Condition ManagementMenopauseMental Health IssuesPhysical InactivitySocial IsolationSubstance MisuseWeight Management

Additional Information  Optional

Do you have the patients consent to make this referral?

Yes

No

Comments  Optional

This field is for validation purposes and should be left unchanged.

What happens next?

A member of the team will contact you within 5 working days, if you have not heard back within this time please contact your GP Practice.