What is Social Prescribing and What Are the Benefits?

We Are Medics -

This is a guest blog by a medical applicant, Sarah Badar

Introduction

Right now, there is so much going on- we have not only seen diseases like the COVID-19 claim lives physically but mentally too. There is no doubt that adjusting to these new changes has been hard for everyone! Especially for those dealing with pre-existing issues. It can also be extremely distressing for healthcare professionals when they cannot provide the type of aid that patients need within a clinical setting and this is where social prescribing comes in!

What Is Social Prescribing?

Social prescribing is often seen as a method of community referral prescribed by GP’s, nurses and other primary care professionals to enable patients to get involved in non-clinical local communities. They assign patients to a community service in order to reach people’s needs by taking holistic approach allowing patients to take better control of their health.

Imagine that you are attending an appointment at your local G.P and have expressed concern surrounding your recent bursts of anxiety due to upcoming exams. Your doctor taking this into consideration suggests that you attend weekly art sessions at a community centre. You agree to this but you are hesitant, after attending three sessions you feel calmer and less worried about your exams as you have taken a new approach in the form of art to help combat this.

This is essentially what social prescribing does, it’s a mechanism for linking people with non-medical sources of support within the community to improve physical, emotional and mental wellbeing (1).

Methods of Social Prescribing

1. Sign posting- Individual sees a form of promotion for social prescribing through a signpost or even a leaflet etc. This then leads the patient directly to the service available.

2. Referral from a G.P- Individual expresses concerns G.P and then depending on what has been collected from the patient history generated and what they feel is the best suitable course of action for the patient, they may medically refer them to a social prescribing activity.

3. Link Worker- Patient attends the G.P consultation and the general practitioner appoints a Link Worker (Workers who are employed in non-clinical roles). The link worker supports the patient towards finding a suitable group, in which they would benefit greatly from in terms of their physical and mental wellbeing while enabling them to develop skills, friendships and resilience.

Benefits of Social Prescribing

Personally, I feel that social prescribing is most efficacious when both parties seem to be genuinely engaging with the concept and following the Enrolment, Engagement and Adherence procedure (2).

  • Enrolment: Primary care professional’s acknowledgement and their willingness to offer a social prescription alongside the patient’s consideration of and acceptance of the prescription.
  • Engagement: The patient’s initial participation and association in the activity.
  • Adherence: Patient’s ongoing involvement with and/or the full uptake of prescribed activity.

Now that that’s been said, let’s discuss some of the positive implications that social prescribing holds.

1. Reduces workload for General Practitioners

We cannot ignore the amount of work that the General Practitioners have to carry out. They are normally our first point of contact when we wish to receive medical treatment. Social prescribing can help relieve the stress of G.Ps of not being able to cater to patients who have social needs by providing access for patients through therapeutic projects which are provided by the local authority and the voluntary sector can help dramatically.

Reports have further shown that implementing methods of social prescribing have cut GP consultation rates by 28% and A&E attendance by 24%. Social prescribing covers 70% of health and wellbeing not provided by the NHS and can often be more important to patients than traditional biomedical care as social prescribing can dramatically reduce their workload.

2. Increase in mental health and wellbeing

By seeking an external source of treatment, this can improve mental health significantly by increasing awareness of skills, activities and behaviours that improve and protect mental wellbeing.

New measures have been adopted to maintain mental health as the individual has been exposed to a community setting leading to an increased uptake of arts, leisure, education, volunteering based activities consequently, reducing anxiety and depression levels.

Social prescribing has been identified as a means of self-management, connecting individuals into non-medical sources of support and managing factors that may have been affecting their health and wellbeing, such as debt, housing and unemployment.

A study showed that of 342 individuals interviewed before and after being introduced to social prescribing in the UK that 265 (77.5%) had an improved well being score.(3)

3. More funding for research available

A considerable amount of funding goes towards the NHS with around £129 billion being spent in 2018/19.

If more people are being referred to available community services, this could cut the amount of spending that the NHS disburses dramatically. The funding could then be used to go towards research and create more innovative approaches within the NHS.

However even with all the benefits social prescribing has, Social Prescribing may not be a long-term fix as this method does hold some ethical concerns. An example of this includes Kimberley Brownlee, a Professor of Philosophy at the University of Warwick who stated how It may seem patronising to prescribe socialising to someone dealing with poor mental health as it poses as a superficial short term "solution" without properly examining the cause. (4)

With the above being said, I wholeheartedly believe that social prescribing has many positive impacts which not only benefit the lives of patients but additionally health care workers working within the NHS. This innovative approach can help improve the overall quality of life significantly. It is expected that in the long run at least 2.5 million people will have access to social prescribing, with the current UK Secretary of State for Health and Social Care, Matt Hancock announcing social prescribing as a priority and will be available in every GP practice by 2024 as part of the NHS “five year forward plan”(5).

References

1. Social Prescribing - HSE.ie [Internet]. HSE.ie. 2018. Available from: https://www.hse.ie/eng/health/hl/selfmanagement/donegal/programmes-services/social-prescribing/

2. Husk K, Blockley K, Lovell R, Bethel A, Lang I, Byng R, et al. What approaches to social prescribing work, for whom, and in what circumstances? A realist review. Health & Social Care in the Community. 2019 Sep 9;28(2):309–24.

3. Woodall J, Trigwell J, Bunyan A-M, Raine G, Eaton V, Davis J, et al. Understanding the effectiveness and mechanisms of a social prescribing service: a mixed method analysis. BMC Health Services Research. 2018 Aug 6;18(1).

4. Apter C. The benefits - and downfalls - of social prescribing [Internet]. MHT. 2019 [cited 2020 Apr 26]. Available from: https://www.mentalhealthtoday.co.uk/news/awareness/the-benefits-of-social-p rescribing-and-a-word-of-warning

5. One PC. Primary Care One - Social Prescribing [Internet]. www.primarycareone.wales.nhs.uk. [cited 2020 Apr 26]. Available from: http://www.primarycareone.wales.nhs.uk/social-prescribing