Social prescribing is 'biggest cultural shift' in medicine for generations, says RCGP chair

Social prescribing is probably the 'biggest cultural shift' in medicine and healthcare for generations,but more needs to be done to realise its benefits, the RCGP chair has said.

RCGP chair Professor Martin Marshall (Photo: Pete Hill)
RCGP chair Professor Martin Marshall (Photo: Pete Hill)

Speaking at an online event run by the National Association of Social Prescribing Link Workers, Professor Martin Marshall said that GPs had always 'operated outside the biomedical model', which is what separated them from specialist colleagues.

However he said general practice had not always had the resources or skills to operate in the 'psycho-social space' until the introduction of social prescribing link workers.

'I think link workers are making a massive contribution to our team effort to really get into whole-person medicine,' Professor Marshall said.

He said that social prescribing link workers had the potential to address practice workload, help practices to work differently and promote a wider approach to the health of communities.

Health inequalities

'What I am seeing increasingly across practices, supported and often led by link workers, is a growing interest in the social determinants of health and a growing interest in addressing health inequalities,' Professor Marshall said.

However, he said that while the introduction of link workers had been an 'excellent start' there was still a long way to go.

'I think we need to help PCNs and practices to understand the potential of link workers more effectively than we've done so far. I think we need to be able to provide better induction, better support. Coming into general practice is quite a difficult environment for new people to work in at the moment because everybody's so rushed so we need to provide a more conducive environment.'

Speaking in the same session, National Association of Link Workers chief executive Christiana Melam said social prescribing was about providing holistic medicine and link workers should be seen as an integral part of the multidisciplinary team.

She said social prescribing was not about 'sign-posting' patients to other services, but working with patients to understand their problems and what they wanted to achieve in order to deliver personalised care.

Social prescribing link workers

However Ms Melam said there were not enough link workers and that some practices had been slow to embrace social prescribing. She questioned why the RCGP was not 'shouting their voice to say "we need some more social prescribers"'.

RCGP Wales chair Professor Peter Saul said that the current workload crisis in general practice meant that many GPs did not have the time to think strategically.

'As soon as you think about strategy, what comes into mind is how working with link workers can open up much wider opportunities for treating patients, and particularly certain groups of patients, and can transform their lives,' Professor Saul said.

'So the work needs to be done is to make more, not just GPs but other members of the primary healthcare team, aware of the role. We need to have more defined communications between link workers and other members of the team, and that should include feedback [on what the link worker has done].'

Impact of the pandemic

Professor Marshall said that it was clear there was variation across the country about whether social prescribing link workers were being seen as a central part of the multidisciplinary team and the pandemic had impacted on this.

'In a number of areas link workers just got dragged into the vaccination programme, which has been really helpful because it's an extra pair of hands, but is that the best use of the skills that they possess? Probably not,' Professor Marshall said. 'So I think the pandemic has set back link workers' purpose. But we're moving beyond that and now is the opportunity for link workers to find their role.'

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