Social prescribers in every GP practice could ease workload, says RCGP

Dedicated social prescribing staff should be integrated with all practices to cut workload, according to an RCGP evaluation of the 10 'high impact actions' identified by NHS England to ease pressure on GPs.

RCGP chair Professor Helen Stokes-Lampard
RCGP chair Professor Helen Stokes-Lampard

The college's analysis of NHS England's 10 high impact actions found that social prescribing - referring patients for non-medical care such as exercise classes or social groups - was among the most effective at reducing GP workload.

Nearly three in five GPs think social prescribing can reduce practice workload, according to RCGP polling, and a review by the University of Westminster of existing research found that demand on GP services dropped by 28% on average following a referral to a social prescribing service.

By contrast, the college found that for some of the other 10 actions 'there is a lack of evidence for a significant positive impact or potential'.

High impact actions

GP practices are required to implement two of the high impact actions in 2018/19 under plans set out earlier this year by NHS England.

The college says GP workload rose 'at least 16% between 2007 and 2014' - and GPonline reported earlier this year that more than half of consultations in general practice are for patients with multiple long-term conditions - near impossible to deliver within 10 minutes.

Funding to broaden practice teams and expand training for existing staff, and public awareness campaigns to encourage self-care and use of services such as pharmacies are also key factors that could help reduce GP workload, the college says.

RCGP chair Professor Helen Stokes-Lampard said: 'GPs will always consider the physical, social, and psychological aspects of the person sitting in front of them, and this means they often identify non-medical needs.

Social prescribing

'Patients might benefit from an exercise class, a social group, or another activity which helps them get out of the house and meet other people. Social prescribing is not a new idea - good GPs have always done it, it just didn’t have a name - but we need to start realising the wider, long-term benefits this way of working can have for general practice, the wider NHS, and most importantly our patients.'

Professor Stokes-Lampard warned that driving up social prescribing would rely on funding to support services that GPs could refer to - and with public health services under threat from cuts to local authority funding that could prove difficult.

She added: 'Ultimately, we need NHS England’s GP Forward View, pledging £2.4bn a year for general practice, 5,000 more GPs, and 5,000 more members of the practice team by 2020 to be delivered urgently and in full. And we need similar promises made and delivered in Scotland, Wales and NI, so that our patients have robust, safe GP care wherever they live in the U.K.'

GPC chair Dr Richard Vautrey said: 'Social prescribing schemes have the potential to have a positive impact for patients as well as reduce GP workload, and we have agreed to work with NHS England to encourage the development and commissioning of these projects.

'However, in order to inform best practice, the evidence base must be expanded, and new and existing schemes should be appropriately evaluated, including considering the long-term impacts on patient outcomes.'

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