GP social prescribing can reduce appointments 'by over one fifth'
A large social prescribing scheme in the South West has saved the NHS money by reducing GP and hospital workload by over a fifth, researchers have claimed.
The team said their report is one of the first major evaluations of the effects of social prescribing - whereby GPs signpost patients to non-medical services - and showed that for each £1 invested into the scheme there was a £1.69 saving.
This was driven by a reduction in the amount of GP visits and A&E emergency admissions among people who tend to seek help frequently from the health service by 21% and 23% respectively.
The evaluation was carried out by researchers at University of West of England as part of a programme of work being run by the Social Prescribing Network - a group co-chaired by NHS England social prescribing lead Dr Michael Dixon.
The report also noted an improvement in wellbeing and mental health of patients who took up the offer of social prescribing.
The NHS Gloucestershire CCG scheme, which has been running since 2014, has made a a social prescribing co-ordinator available to every GP practice through seven 'hubs'.
Under the the £480,000-per-year programme, GPs can refer patients who present for non-medical reasons, or whose health needs need to be better managed, to local services including arts groups and exercise classes, and organisations offering help with legal problems or home life.
A total of 2,047 patients were referred to the service - mainly by GPs - up to August 2016, for a range of problems with mental illness, benefits, or housing as well as help with health and fitness, carers support, social isolation and memory loss. Most (81%) took up the offer of help through the local social prescribing hub.
The study found that:
- For the patients in the trial, GP appointments fell by 21%, while GP phone calls were cut by 6% and the number of GP home visits fell by 26%, in the six months after referral compared with the six months before.
- There was also a 23% reduction in A&E admissions amongst referred patients in the six months after compared with before - whereas emergency admissions increased amongst patients who did not engage with the service.
- Patients using the service also experienced improved wellbeing and mental health at six months after being referred, with statistically significant improvements seen on standard health questionnaires.
- The total cost to run the scheme for one year cost £480,819 (around £235 per patient), with savings estimated at £1.69 for each £1 investment.
The findings come as NHS England is considering proposals which would see CCGs potentially receiving £1 per patient to implement social prescribing schemes and as the Scottish Government offering practices support to the value of £35,000 to host link workers.
But the findings come as an evaluation of an East London social prescribing pilot scheme found that referring patients for social activities such as gardening or cooking did not cut subsequent GP consultations or improve patients’ health outcomes.
Report author Dr Richard Kimberlee, a public health researcher who helped found the Social Prescribing Network, said he was 'very much convinced of the great benefits social prescribing brings to GP practices, particularly among those patients taking up a lot of resources'.
‘In terms of utilising primary care, there was a significant reduction in visits and phone calls...
'With a diminishing welfare state, the pressure on health service providers is exponentially growing and they need to think quickly to stem the tide.’
NHS Gloucestershire CCG clinical lead for social prescribing Dr Simon Opher, a local GP, said the study 'reinforces the increasing body of evidence which shows that social prescribing can help people who wouldn’t necessarily gain much benefit from the healthcare system'.
He added: 'People in Britain today are less engaged within their communities than ever before and this project supports them to reconnect. Social isolation has been said to be one of the major causes of ill health: social prescribing reduces this burden and can therefore reduce the stress on the NHS.’
The rise of social prescribing
Health secretary Jeremy Hunt has voiced his support for GP social prescribing and NHS England's GP Forward View called for a greater emphasis on the approach.
The King's Fund has also given its backing, saying GPs should prescribe gardening to patients with conditions such as heart disease and dementia.
Despite this, it remains uncertain how effective social interventions are - and GPs have conflicting opinions over role they have in general practice, with some arguing it provides GPs with alternatives to traditional care to help manage patients and others branding it 'a waste of time'.
Dr Michael Dixon - whose own GP practice has employed a social prescribing advisor for several years - has been appointed NHS England's lead on social prescribing and has been lobbying for CCGs to get funding in the region of £1 per patient to enable every GP practice to employ a social prescribing co-ordinator.