What is social prescribing?
Social prescribing allows GPs to refer patients to non-clinical services, which are often run by charities, with the aim of helping then to take greater control of their own health.
There are different models for social prescribing schemes, but the University of Westminster’s social prescribing network says these generally ‘provide a range of non-medical options that could be available when a person has needs that are related to socioeconomic and psychosocial issues.’ The main aim is to take a holistic approach to health.
In most examples of social prescribing a link worker, or navigator, will work with patients to access local groups best suited to their needs.
Examples of social prescribing schemes include cookery classes and healthy eating advice, volunteering, sports and exercise groups, gardening, arts activites and group learning.
GPs spend a significant amount of time dealing with patients’ social problems, such as debt and housing issues. Social prescribing also aims to provide GPs with somewhere to refer these patients on to, helping the patient and freeing up GP time.
Does social prescribing reduce GP workload?
NHS England has backed social prescribing as one of its 10 high impact actions, which are aimed at freeing up GP time to enable them to deliver more clinical care.
Last week, analysis by the RCGP found that social prescribing was among the most effective of the 10 high impact actions at reducing GP workload. It called for dedicated social prescribing staff to be integrated into practices.
A study by the University of Westminster found that social prescribing was associated with a 28% reduction in GP appointments.1 It also helped to cut A&E attendances and outpatient referrals. However the review also said further research was needed to fully evaluate social prescribing's impact.
The King's Fund has also pointed out that robust and systematic evidence on the effectiveness of social prescribing is very limited. Many studies are small scale and rely of self-reported outcomes.
What do practices think about social prescribing?
However, practices that have taken part in social prescribing initiatives are positive about its impact. Over four years ago, Storrsdale Medical Centre in Liverpool began hosting tea parties for isolated patients on its list.
Speaking to GPonline's sister site Medeconomics, practice manager Deepa Gnanasundaram explained that staff had noted a number of calls from elderly people they felt unable to help and after discussions with charity Contact The Elderly the practice decided to hold tea parties.
‘We hold the tea parties in the surgery,’ Ms Gnanasundaram said. ‘It’s local and not an alien environment. We advertised in the practice and some patients volunteered to bake or help out in other ways, as did every member of staff. We started with six patients one Sunday a month and now we have 15, recommended by the clinician.
‘We make it exciting, there’s a lively atmosphere. These are lonely people and we made them happy.’
She explained that there were direct benefits for both the patients and the practice. The patients had an opportunity to speak to a GP casually at the event rather than booking a consultation, which meant that they attended less frequently for appointments. The initative also had a positive effect of the practice's standing in the local community and its list size has increased because of the work they have put in.
‘Fundamentally, the benefits are more than the cost,' Ms Gnanasundaram concluded.
Where can GPs find out more information?
The Social Prescribing Network is a good place to start, you can access their information here.
NHS England also has a forum of resources aimed at supporting social prescribing, which includes videos and practical examples of how initiatives work on the ground. You can find this here.
1. Polley M, et al. A review of the evidence assessing impact of social prescribing on healthcare demand and cost implications. University of Westminster, June 2017.