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Social prescribing can free up GPs’ time and save resources

May ease pressures on general practice and NHS – but not an alternative to investment

Louise Prime

Wednesday, 21 February 2018

NHS England’s lead for urgent care has urged health and local government leaders to seize 'the greatest opportunity in 70 years' to work together to improve local communities’ health, and make the best use of resources. GP leaders said GPs have always engaged in social prescribing without using that term, and agreed that this has the potential to help free up some GPs’ time that can then be used caring for patients with the most complex health needs, and thus ease pressures on general practice and the wider NHS. But they also pointed out that this must not be seen as an alternative to investing in our general practice service.

Professor Keith Willett, NHS England’s medical director for acute care, said today that the two sectors had historically struggled to overcome their financial, cultural and operational differences, preventing them from adapting to public need. But he pointed out that with 100,000 beds and 1.3 million workers in the NHS versus more than 300,000 beds and 1.5 million workers in social care, the two sectors are becoming increasingly interdependent. He said changing health and care needs, the imperative of financial pressures, and the advent of integrated care systems means the conditions are now right for 'a major shift in attitude'.

Professor Willett said: “You can’t understand the complex needs of people until you’ve listened to a patient or carer talking to their GP or ringing 111 or 999 for a local mental health response or to sort out a care issue for an elderly person who then ends up going into hospital.

“The NHS traditionally presents change from an evidenced-based and population-benefit perspective, and local government often sees such change from the individual constituents’ day to day life circumstances and their holistic social need.”

He described several schemes, identified with support from the District Councils’ Network, where local authorities and the NHS have formed partnerships that had improved services in their communities. These include:

  • In a jointly funded NHS and council health coaching service in Wealden in East Sussex, local GPs have prescribed community activities from the council’s not-for-profit leisure operator; 29 patients who regularly visited their GP in the six months before receiving coaching reduced these visits by 61% in the following six months.
  • In South Norfolk, 187 patients have accessed a social prescribing scheme under which patients who attend surgeries for non-medical issues can be referred for direct access to practical help and advice; 98% of cases were not escalated to statutory services, and there is greatly increased partnership working between GPs, other health professionals and district council services.
  • In Haverhill, Suffolk, a pilot scheme has seen more than 50 people with low mood and long-term health conditions benefit from a partnership to improve wellbeing and reduce isolation, as GPs refer patients to meet a ‘LifeLink’ Coordinator to help them connect with people and activities in their area. The programme will help to avoid unnecessary repeat GP and other appointments.
The Royal College of GPs welcomed the positive impact on the NHS of these and other schemes nationwide. RCGP chair Professor Helen Stokes-Lampard pointed out: “Sometimes, what our patients need … is encouragement to take an exercise class, or any activity that will get them out of the house and mixing with other people. … Social prescribing is something that experienced GPs have always done – it’s just the actual term was not widely used until recently. Benefits we have seen can include prescribing less medication, fewer follow-up consultations, and engaging patients more with their own health. Linking patients with local voluntary organisations can also help to give people a sense of purpose.”

But she warned that for social prescribing schemes to work well, it’s essential for different sectors of health and social care services to work together constructively, with input from local councils, and for there to be enough community services to meet demand.

She added: “Social prescribing initiatives can potentially help free up some GPs' time which can then be used caring for patients with the most complex health needs, and thus ease pressures on general practice and the wider NHS – but they must not be seen as an alternative to investing in our general practice service.”

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