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.