Self Care & Social Prescribing (Kirklees) Care Pathway

Review in progress

Disclaimer: The guidance contains helpful primary care information for management of referrals and up to date referral criteria. These guidelines are locality specific to best reflect local services. This guidance does not override or replace the individual responsibility of healthcare and social care professionals involved in the delivery of care to make informed professional judgements appropriate to the circumstances of the individual.


This guidance refers to:

  • Supporting patients to have the right knowledge, skills and tools to confidently manage their health and well-being through self-management and self-care
  • Supporting adults in the Kirklees district to feel healthy, remain independent and address issues of social isolation.
  • Referrals to self-care and social prescribing services for people aged 18+ living in the in Kirklees with a long term health condition

This guidance does not cover:

  • People who do not live in Kirklees
  • People under 18 years of age

Service Information

Evidence shows that when people are empowered to become more activated in their own care, they benefit from better health outcomes, improved experiences of care, resulting in fewer unplanned care admissions. Self-care is crucial in addressing demand in practices. It can also help with referrals, patient satisfaction and service quality.

When the principle sources of information come from GPs or other trusted health professionals people are much more likely to engage with self-care and self-management.

When possible make every contact count through providing brief information that helps people to be engaged in their own care by:

  • Asking open questions
  • Keep advice brief and relevant to the person
  • Signpost the person to the right information and support

Social Prescribing

  • Social prescribing, sometimes referred to as community referral, is a means of enabling GPs, nurses and other primary care professionals to refer people to a range of local, non-clinical services. Recognising that people's health is determined primarily by a range of social, economic and environmental factors, social prescribing seeks to address people's needs in a holistic way. It also aims to support individuals to take greater control of their own health. For adults living in the Kirklees District this service is provided by Better in Kirklees
Better in Kirklees
  • Better in Kirklees supports people living with a long-term health condition to become more active and involved in their community. Through Social Prescribing, connecting people to groups and activities close to where they live based on their interests.
  • Anyone over the age of 18 in Kirklees living with a long-term health condition can join the Better in Kirklees programme including: people with a physical disability, mental health condition, learning disabablitiy, sensory impairment, dementai, drug and alcohol issues, and unpaid carers.
  • Referral information
    • GP practice staff, social worker or Gateway to Care referral only.
    • Referral form can be downloaded from the website or by contacting the team on:
      • Tel: 01924 846 808
      • Email:

Self Care Services

  • Kirklees self-care services are available to all people aged 18+ living in Kirklees with a long term health condition. The services are:
Kirklees Health Trainers
Practice Activity and Leisure Scheme (PALS)
  • Kirklees exercise referral scheme for people with LTCs where people can take part in group or individual activity programmes
  • Residents in Kirklees who are aged 16 years or older and have or are at risk of developing health conditions such as: heart disease, raised blood pressure, low self-esteem, mild anxiety/ depression, stroke, diabetes, respiratory problems, arthritis/ joint pain, osteoporosis or similar, weight control problems, fallers or those at risk of falling, chronic/persistent pain.
  • Referral Information
Expert Patients Programme (EPP)
Looking After Me (LAM) for carers
  • Peer led Free courses for all adults who are unpaid carers of people with a long term health condition, to give practical help and support to manage a day to day caring role and to talk with other carers.
  • Referral Information
    • Health or care worker or self-referral
My Health Tools
  • online tool providing access to useful resources to help people manage their long term health conditions
  • can be used by all adults in Kirklees with a long term condition.
  • Access via the website
  • For MHT Flyer click here
Better in Kirklees - see social px above
Everybody Active
  • For all adults living in Kirklees who would like to get more active and gives you free access ideas, tips and information on a range of activities
  • see website to access

See additional service information for Mental Health, Cancer, Arthritis and more generic services

Additional Services

The following additional services may also be useful for people living with health conditions in Kirklees:

Mental Health
  • Community Links (Kirklees)
    • Social enterprise offering support for people with a wide range of mental health issues which includes services for: woman with complex needs inc personality disorder, substance and alcohol misuse, recovery service, dual diagnosis and people with multiple needs who disengage with services
    • Referral information for each service can be found on the website
  • S2R/ Support 2 Recovery
    • a mental health charity working across Kirklees to promote mental wellbeing and positive mental health.A range of courses and sessions that explore what we mean well-being and look at a range of tips, techniques and therapies that everyone can use to improve their own well-being.
    • For anyone who could benefit from improved mental wellbeing and positive mental health.
  • Active for Life
    • a Kirklees wide exercise referral scheme aimed at improving mental health.
    • Specifically designed to enable inactive people with enduring mental health problems to discover the benefits of being more active. Referrals via health professionals only.
    • Active for life leaflet
    • for further information contact - Saul Muldoon: 07976194375
  • Steps for Life
    • an exercise referral programme for people living with dementia and provides support, motivation and advice with a chance to try out a range of activities and enjoy the social side of meeting other people.
    • The scheme is for inactive people who have early onset dementia and are a resident in Kirklees.
    • Referrals are via the Memory Service.
    • Contact Louise Taylor: 01484 234092
  • For additional mental health crisis and self care information click here
  • Creative Minds is all about the use of creative approaches and activities in healthcare; increasing self-esteem, providing a sense of purpose, developing social skills, helping community integration and improving quality of life. Various projects across Kirklees for different audiences. Up to date project list here:
  • Age UK - Calderdale & Kirklees provide a wide range of services and support to older people in the local community on a range of issues including benefits, money matters, consumer issues and much more at their centres in Huddersfield and Batley. - Tel No: 01422 252 040

Assurance & Governance

  • This guidance was developed on: 03.2017
  • This guidance was ratified by: The OSCAR Assurance Group
  • Date ratified: 05.2017
  • Publication Date: 05.2017
  • Review Date: 03.2019
  • Ref No: LW7 - 03.2017
Any feedback or suggestions to improve this guidance should be sent to:
Only the electronic version is maintained, once printed this is no longer a controlled document


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