How we used social prescribing successfully
Dr Mohan Sekeram
Last year, two practices in Merton conducted a year-long social prescribing pilot to help us understand the effectiveness of social, community-based solutions to treat patients. The results underline the power of social prescribing to turn lives around, where used as an appropriate compliment or alternative to medical treatment.
This is good news as the NHS prepares to roll-out social prescribing more widely, training up 1,000 experts as part of its long term plan. I firmly believe that social prescribing is one of the integral drivers of personalised care.
But what does social prescribing really do? It sees link workers take referrals from GPs, before spending time with patients, offering emotional support and connecting them to community groups. The needs of these patients have a non-medical root cause and link workers help tackle these issues with non-medical solutions.
The practices involved saw patients being referred to a wide range of community services such as walking groups, gardening groups and local community centres for financial, housing and bereavement support. This has strengthened links between primary care and voluntary sector.
The pilot showed that over three quarters (77%) of the patients reported improved health and wellbeing. Additionally, alongside patient benefits, there was a marked reduction in service use; GP appointments were reduced by a third (33%), and A&E visits halved.
Of course, we cannot attribute this reduction solely to social prescribing, but programmes in other areas of the UK, from Bexley to Rotherham, have seen similar results.
Over half of UK GPs think that social prescribing can help reduce their workload. My practice identified 20% of patients who were actually in need of a non-medical solution, and by signposting them to this support, we have been able to free up capacity to focus on medical cases.
This also supported other ‘active signposting’ initiatives in the local area, which encourage people to seek out community groups in their local area. Putting patients in touch with support networks within their community therefore strengthens the resilience of the community as well as the individual.
Difficulty with financial management – which can be a huge source of anxiety for people - is also a common reason for referrals
While helping free up appointments in primary care, social prescribing can also increase the impact on the voluntary sector. It is important to include voluntary sector organisations in the journey and identify where support will be required.
Patients referred to social prescribing programmes are most commonly struggling with mental health issues and long-term physical conditions. Difficulty with financial management – which can be a huge source of anxiety for many people - is also a common reason for people being referred.
I have seen first-hand how the encouragement and support patients receive from link workers has helped them to feel more empowered and resilient.
One patient visited me because she was struggling with stress, depression and anxiety, and was partnered a link worker. She says the encouragement and support she received stopped her from feeling so isolated.
Another patient was being treated for depression with anti-depressants, and signed off work as sick. He was referred to a link worker who identified a role as a chef in the local community centre. This improved his self-esteem and he was able to return to work and stop taking medication.
Based on the results we saw, the expansion of link workers through the NHS long term plan will make a huge difference to the lives of many patients who are struggling with social challenges. Thirteen practices in Merton now have link workers and they will be in place across all practices in a few months' time.
My experience of using social prescribing as an approach to solve issues, particularly around mental health, underlines the importance of looking at problems holistically and using non-medical options, and reinforces the view that a medical response is not always needed.
Here in Merton, we came up with the slogan ‘Don’t medicalise… socialise’ to highlight these opportunities, and I would wholeheartedly recommend social prescribing to other GPs to promote good health and wellbeing.
Dr Mohan Sekeram is clinical lead for social prescribing at Merton and Wandsworth CCGs and a GP in Mitcham, south London