Why social prescribing needs to be given a chance
Letter from Dr Marcello Bertotti, Senior Research Fellow, Institute for Health and Human Development, University of East London
I am writing in response to the article entitled 'Social prescribing scheme "did not cut GP workload or improve patients" health' published in Pulse in August. This article drew heavily on evidence produced by an evaluation of social prescribing in City and Hackney led by the University of East London and Queen Mary University of London. As one of the leads of that evaluation, I want to highlight another side to the story.
Sally Hull, a colleague involved in the evaluation and interviewed as part of the initial Pulse article, concluded that we need more rigorous research to establish the impact of social prescribing rather than arguing that social prescribing is not cost-effective or beneficial for patients.
We also concluded that the evidence shows a gap between qualitative and quantitative evidence with the former showing much more positive results than the latter. However, the article does not even mention the results from the qualitative research and is instead solely guided by the results from the quantitative work.
Furthermore, recent long term analysis conducted by Queen Mary University showed a statistically significant reduction in GP consultation rates one year post referral when compared with a matched control group, which actually saw an increase in GP consultation rates. Although these results suffer from a potential problem with ‘regression to the mean’, it does show that we cannot be conclusive either way and also shows that the impact of social prescribing on patients may take longer than initially anticipated.
Social prescribing seems to have rapidly become a ground for ideological battle with critical comments about waste of NHS resources, and GP comments about ‘we are doing it anyway’, or ‘patients are not stupid, they can use the internet’. Social prescribing is there to support and assist GPs and should not be seen as the enemy. Whether some GPs like it or not, 20% of patients consult their GP for problems that are primarily social rather than medical which suggests that referral to non-clinical treatment available in the community may be helpful. A social prescribing link worker can act as an interface between primary care and the third sector and provide patients with time to explore their feeling, something that is not currently possible during busy GP consultations.
Although I would not want to deny that social prescribing has its limitations and needs further improvement, it is important to give it a fair chance to prove its potential worth rather than attempting to kill it with only one side of the story.
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