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GP social prescribing efforts may fail due to funding cuts, warn researchers

Social prescribing schemes in general practice are unlikely to be a ‘magic bullet’ because of austerity and funding cuts, researchers have concluded.

A team at the University of Glasgow who carried out a series of interviews with community link workers in general practice and the third sector and community organisations they refer to, found that without proper funding for support services, such schemes may not ‘achieve their potential’.

Writing in the British Journal of General Practice, the researchers also pointed out that if community organisations cannot take on the extra referrals being made to them because of lack of funding, link workers will be left to ‘absorb the workload that GPs pass on’.

‘Without involving community organisations in the planning phase, to determine whether their role is realistic, and tackling funding issues that they face, the efficacy of initiatives to increase the role of community organisations in achieving public health goals is questionable,’ they concluded.

The research did show that the organisations involved were generally positive about the approach and the benefits of linking up primary care and the third sector and vulnerable patients having a ‘case manager’.

The study was done on a social prescribing scheme which was set up in Glasgow in 2014 but a national programme is now being put in place.

A target has been set by the Scottish government for 250 community link workers in general practice by 2020/21.

In England, the Government recently promised a £4.5m investment towards social prescribing schemes such as gardening or arts clubs

Study leader Dr Kathryn Skivington, a research fellow in the University’s Institute of Health and Wellbeing said: ‘We have to think about social prescribing in the context of austerity and what is achievable for these organisations.’

She added that there was a real lack of evidence on effectiveness of interventions in social prescribing and more evaluation would be useful.

‘Community link workers and community organisations were enthusiastic about working in general practice and there was a real appetite to be linked in with GP practices.’

Dr Andrew Buist, deputy chair of BMA Scotland’s GP Committee, said community link workers were part of the range of professionals that can help to relieve some of the ‘unmanageable workload’ faced by GPs.

‘Those patients who benefit from their help often feel better supported with a range of health and social challenges thanks in large part to the work that they do,’ he said.

‘Plans to deliver a significant expansion of links workers in Scotland complement the approach of the wider new GP contract, which will see GPs in Scotland supported by wider teams of professionals.’

He added that while social prescribing has the potential to be of significant benefit, the capacity of third-sector organisations to take on large numbers of individuals can vary significantly.

‘Ensuring that such organisations have the resources they need is a challenge that needs to be addressed.’

Br J Gen Pract. 2018 Jul; 68(672): e487–e494