This site is intended for health professionals only

At the heart of general practice since 1960

Read the latest issue online

Gold, incentives and meh

GP practices could receive £1 per patient to fund social prescribing advisor

Exclusive General practice could receive an extra £1 per patient towards improving access to social prescribing by 2017/18, according to NHS England’s clinical champion for social prescribing.

Dr Michael Dixon told Pulse that he was in talks with commissioners about the extra funding, which would pay for practices to employ a social prescribing ‘advisor’ that would provide GPs with the means for offering patients a ‘solution that isn’t medicine or a procedure’.

The advisor would direct patients facing issues such as loneliness to appropriate support services in the area.

Dr Dixon said the scheme, which has been ‘met with interest and positivity’ by the health secretary and others at NHS England, would reduce workload pressure on GPs, who are currently ‘under siege’.

He said: ‘It’s believed, first of all, that social prescribing works and is not only important for patients but also very important for general practice because, where it works well, it is reducing pressure on general practice.’

Dr Dixon, who is also a GP in Devon, funds a social prescribing advisor in his own practice of 20,000 patients, which he said costs £23,000 each year to run.

He said: ‘If we really want to kick start this and get this going, I think a pound per patient would do it and that's actually pretty tiny when you think about the amount that’s gone into other initiatives.' 

He added that the funding should have ‘no strings attached’ and instead ‘should just be an extra service they can provide which is paid for by the CCG’.

Dr Dixon said GPs should be able to access advisors several ways, including a ‘practice-attached’ advisor that is paid for by the CCG or a ‘hub and spoke’ system for smaller practices where advisors go out to visit practices.

Dr Dixon said he would ‘very much hope’ the extra funding to be in place by 2017/18 ‘at the very latest’.

But he said details of how the funding will be delivered, whether centrally or through STPs, is what is ‘holding things up at the moment’.

However, there have been recent studies that have cast doubt on the effectiveness of social prescribing.

A review by York University health economists, published last year, concluded that only few studies had supported the use of social prescribing, all of which were of ‘poor quality’.

The researchers said: ‘There is little in the way of supporting evidence of effect to inform the commissioning of a social prescribing programme.

‘What evidence there is tends to briefly describe the evaluation of small-scale pilot projects but fails to provide sufficient detail to judge either success or value for money. Evidence on the cost effectiveness of social prescribing schemes is lacking.’

Another recent study from NHS City and Hackney CCG, in east London, analysed data on healthcare use, GP attendance and prescriptions for 381 patients referred to its social prescribing pilot and found that referred patients had much higher consultation rates and used more prescription medications before referral than controls and this remained the case eight months after referral to the scheme.

Dr Sally Hull, a GP and reader in primary care development at Queen Mary University London who led a review of 381 patients referred to social prescribing pilots in NHS City and Hackney CCG, ‘there was no demonstrable impact on GP consultation rates’ and ‘we were not able to show a change in outcomes such as levels of depression, anxiety or confidence in self-management’.

NHS England included social prescribing in their ‘10 High Impact Actions’ to release GP time launched in July, but said they were not aware of any current work to progress funding allocation for social prescribing.

Readers' comments (43)

  • "I am just glad 1010 thinks that all are good ideas."

    I didn't say that. I simply pointed out that it's easy to criticise and not so easy to put forward constructive ideas of your own.

    "I am also glad 1010 is not my PM"

    Well we know nothing about each other so I won't just to the same ignorant conclusion, suffice to say that I enjoy working with open-minded, innovative GPs who accept that things need to change, rather than just criticising everything and everyone else unless they simply chuck money in our direction. That simply won't work on its own.

    Unsuitable or offensive? Report this comment

  • "This needs to be commissioned on an area wide basis with practice based advisers rather than having each individual practice trying to do it themselves."

    Agreed - but it doesn't need to be commissioned that way. Forward thinking groups of practices can pool the money and deliver the service at a wider level to make it more cost effective.

    Unsuitable or offensive? Report this comment

  • 12:53 - Which is what we have locally by way of a third sector - Single Point of Access. The shame is that the SPOA for 3rd sector is different to the SPOA for social care/work/CMHT which means that GP's need to negotiate the two individual single points of access and complete two wildly different forms, which are different again from the one they'd normally use to refer pt's to secondary care. For a scheme to reduce GP workload and complexity, it's achieved the absolute opposite.

    Unsuitable or offensive? Report this comment

  • 2:03 - That's not ideal, but it can be done. The area I used to work in didn't need a referral at all, patients could self refer or GP's simply sent a task or an email...

    Unsuitable or offensive? Report this comment

  • Why would any practice do this for free - THATS ODD - in the days of goodwill and not GPs earning £15K a month didn't they do it for free because patients mattered?!!!

    Unsuitable or offensive? Report this comment

  • A pound a patient? Buttons!!

    Unsuitable or offensive? Report this comment

  • Drs - do you never see a patient and think why am I seeing this person - is the concept of social prescribing worth considering? Perhaps the detail of the commissioning could be improved with your input

    Unsuitable or offensive? Report this comment

  • single handed practitioner with list of 2500 can get £2500 to employ some expert with living wage, provide additional room, extra cups of tea and tissue paper to wipe, heating telephone bill. it will improve patient care?? small practices (a business) will jump to that profitable opportunity !!!!
    where do these people live who make such a clever decision.

    Unsuitable or offensive? Report this comment

  • GP's deal with physical health problems, social services deal with family / emotional problems and the folk that simply don't know how to cope with breathing to stay alive1

    Unsuitable or offensive? Report this comment

  • I do't know either the GP nor the PM but why is social care coming our way as well as 'ologies' and urgent HVs, on top of he 40+ patients I see each day.
    Let us not fight folks, it is just I find this job just getting impossible, so though I can understand the PM's view of different work as a solution, I can easily see the GP's view point of extreme exhaustion.
    I am minded we do 90 % on 7% of the budget as it is.
    Anyway, it is not my problem much longer.

    Unsuitable or offensive? Report this comment

View results 10 results per page20 results per page50 results per page

Have your say