Over half of people on low incomes told the Social Publishing Project their health is worsening and it's down to money worries. So is it time to look harder at non-medical ways to reverse the trend? Could health services pool resources (and save money) by making use of advice services to improve patient wellbeing?
The concept of “social prescribing” has been buzzing around for several years, the idea being that GPs and other primary care practitioners “prescribe” non-medical, community-based activities that benefit patients’ health rather than fund Big Pharma.
Patients are empowered to take responsibility for their own health. Social prescriptions can include a Zumba exercise class, volunteering, cookery, crafts and even fishing.
Or they can involve debt advice such as that of Liverpool Advice on Prescription Programme, delivered by Citizens Advice services in the city. LAPP’s team has answered over 3,000 enquiries to help patients manage over £1.8 million in debt. Such interventions can stop poverty and debt spiralling into illness.
In fact, Citizens Advice has thrown its weight behind social prescriptions, having produced this briefing for England that calls for councils and Clinical Commissioning Groups (CCGs) to work better together.
The 2010 Marmot Review (Fair Society, Healthy Lives) of health inequalities identified social prescribing as an, “approach [that] facilitates greater participation of patients and citizens and support in developing health literacy and improving health and well-being”.
It identified additional NHS healthcare costs linked to inequality as being well in excess of £5.5 billion per year. If it is known that social prescriptions can cut the NHS bill , professionals should by now be sussing that alternative health approaches may help prolong the floundering NHS as well as the lives of clients.
However, despite the concept’s growing popularity, the University of York has produced research to show that there is little good quality evidence that social prescribing is cost-effective. It's up to you to work out the cost/benefit.
WHERE IT WORKS...
GP-led projects are mushrooming all over – see below for some great examples of where it works. And Clinical Commissioning Groups (CCGs) are increasingly looking at social prescribing, bringing innovations in their tow.
For instance, Leeds South and East CCG is looking for a local individual with experience of loneliness and mental health issues to help design its new social prescribing service.
And the innovative Bromley by Bow GP centre in East London is running seminars over the next few months. The centre has issued social prescriptions since 1997, referring patients to employability programmes such as work experience placements in local settings to increase learners’ confidence. It also has “employment brokers” to support local people into employment.
Take a look at some examples of successful social prescribing:
- The Green Dreams project in East Lancashire is a social enterprise that provides social support to isolated and unemployed patients across 13 GP practices. It helps with finance, debt, housing and benefit problems, as well as self-esteem and confidence issues.
- Healthworks, a specialist wellbeing organisation based in Sheffield, has started social prescribing employability and health services to people referred from GPs.
- In Rotherham, activities such as lunch at the local rugby club is being prescribed by local GPs. More than 3,000 patients with long-term health conditions have been referred for a social prescription since September 2012. The project is funded by the local CCG and Voluntary Action Rotherham.
- From health prescriptions to doses of learning: The Wellbeing College, an initiative running in Bath and North East Somerset, offers courses from financial and housing advice to how to deal with dependency and addiction for anyone over 16 years who wants to manage their own health and wellbeing.
IN OTHER NEWS...
Taking social prescribing one step further is Charnwood Community Medical Group in Leicestershire which will refer patients to a volunteer-run clinic. Volunteers from local patient participation groups will advise patient peers on activities such as sports, volunteering, dance classes and book groups.
Healthy Connections Wigtownshire has just launched for patients aged 18 and over who frequently attend primary care. Risk groups such as low income single parents and those with long term mental health issues should be able to benefit. Prescriptions include a strollers club, gardening, healthy reading and welfare and debt advice.