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Social prescribing
Social prescribing is about helping people to find ways to improve their health and wellbeing by linking them up with what is going on in their local area. It enables people to access services that meet their wider emotional, physical and social needs.
Together with the Healthy London Partnership, NHS England and the Social Prescribing Network for London and following engagement, City Hall has developed a draft social prescribing vision for London.
We'd love to hear what you think.
Have you heard of social prescribing before and what do you think about it? Do you know if it’s available in your area? Would you use a social prescribing service if it were offered to you?
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I’ve never heard of it and think it’s a brilliant idea
Sounds like a great way to meet people in the local community , learn new skills and combat lonliness
I’m very surprised. Park Runs provide both an opportunity to combat loneliness as well as vital,exercise.
The idea is that when people present with health problems at GP clinics, they still receive clinical attention to the health problems but also there is recognition of the other factors that may be causing or worsening their health and wellbeing; and some of these added issues can be solved by social prescribing. You are right that loneliness and isolation can make health problems worse and also Roger's comment is right that exercise can often help. However, if someone has been ill and is trying to recover, they may need more support to be able to engage with activities, especially if their mental health is suffering
I'm lucky enough not to need it myself but I'm all for promoting activities for those who are isolated or stressed. It would help to do this if leisure centres were open longer for example.
It is a wonderful thing and I have heard a lot about it but it is not free. If the charities that provide the services that will be subscribed are to function well, they need to receive funding for their work!
So when your taxes are increased again do not complain. People need to learn to help themselves, perhaps start going to church. And the charities that operate this all get subsidising grants from the taxpayer.
I've heard of it as it's been in the news recently. I think it's a very good idea - excellent way not only of improving physical and mental health without it costing the NHS a lot of money, but also of reducing social isolation and encouraging people to interact more in their local communities and forge local ties.
I’m hearing of this social thing for the first time
If you have a local library, a GP surgery, local shops and cafes with signs in the windows, some kind of adult education centre - you will find all sorts of community activities, groups, classes, special support groups. They have always been there, but there are now far fewer of them, and much of it costs much more than it used to (E.g. Adult education classes). It has just never been co-opted by government before as a substitute for proper diagnoses, referals for tests and referals to appropriate specialisms where necessary.
It is not new, it has just been re-packaged and given a PR spin.
On the surface this seems in equal measure a good idea, a cost saving idea, a loony left wing idea and a vanity project.
I question the independence of the concept leaders, Is it but a government mouthpeace that divests itself of national heath accountability or is it a means of building community through shared goals, ilnesses or conditions.
I am suspicious. It sounds like the worthy preaching to the needy, but missing out on the majority. And the majority will be the ones that fund this.
No - it uses volunteers to do the work.
thanks Caroline. who appoints those running the groups. are they alteristic or are there motives behind their involvement?
I don't trust this idea. It's a cost saving idea first and foremost. If the government want to save money, let them stop giving sexchange operations on the NHS.
Oblige doctors to work soley in the NHS for 10 years after they have qualified.
The idea stems from abundant and convincing evidence that when patients present to their GP with health problems, a large part of the factors affecting the patents' health that they want to discuss with GP are not clinical at all, but are within the realm of social support. Social Prescribing provides a structure for ensuring that patients are supported to tackle the social issues that impair their health, so that GPs can get on with their clinical role and have some resources within their clinics to connect patients with the support they need. This will improve patients' wellbeing, reduce time spent with GPs on non-clinical problems and therefore eventually allow GPs to focus on medical issues. Eventually that must result if successful in reduction of NHS costs for non NHS causes. It is therefore practical, not loony, and I cannot see how anyone cpould flatter their own egos. It is to improve patient focus and also to address obvious inequalities in health outcomes
I think you are astute to realise that it depends for its success on community networking. My experience is that many agencies, including local authorities, health, social services and social support fail in their statutory duties to meet citizens' needs because they are all working within their own isolated frameworks, and do not collaborate with each other and with community agencies such as charities, who seem to be able to focus on individuals a lot better. It is my hope that social prescribing sstems will bridge these gaps and help agencies to interact to better effect, for the benfit of patients and their carers
Brilliant, so glad this approach is being expanded.
Curious as to where the person offering Social Prescriptions sits within the network of health & social services, and whether there are plans to standardise this structure. Would be helpful for social prescriptions to sit on integrated health & social care record, so the history can influence care planning in later life.
It's a win-win for gov / NHS saving ££ and public having better quality of life. Exciting!
Seems good; but I did it for a while and felt awkward trying to guess who wanted to be asked if they needed help, and who would be annoyed...because they might have already been asked yesterday.
Perhaps more online and 'phone 'advertising' would be effective; maybe not cost-effective?
But all this has always been on offer in GP surgeries, leaflets and brochures for all this has always been in all of them. Nothing else to do but sit there and read them while waiting and waiting to see the GP. It is getting harder and harder to persuade a GP that you have a real physical health problem, and that they should do some testing, some diagnositics, and refer to a specialist if necessary. They will do almost anything to avoid making referals to outpatients services. This approach is downright dangerous.
A good idea in principal, but a bit backward-thinking. The main reason why people are being less active is because our city is not designed to enable active travel. If our city had a great network of protected cycle lanes, and every street was pleasant to walk down, then we wouldn't need to prescribe activity to people, most people would already be getting their fix of daily activity by cycling or walking to the shops, to their friends, to work or to other places of interest (see what they’ve managed to achieve in many Dutch cities and towns). Cycling and walking is a very social activity and good for mental and physical wellbeing. Active travel is by far the best way of getting you required amount of daily exercise without having to set aside specific time or dress in silly clothing. But sadly, in most of London, active travel isn't viewed as a safe or convenient option due to lack of infrastructure to enable people to make the correct life-enhancing choice.
London has an excellent transportation network of rail and bus services. To steal more of the roadways specifically for cyclists will do no more than reduce traffic crawl even more and by doing so increase pollution. A bicycle is by law a vehicle, use it as a vehicle and observe road laws just as every other vehicle is required to do.
@Hampshirehog Most of London does indeed have a good public transport network, but we are talking about activity. It makes me laugh that you view the reallocation of public road space as "stealing". It’s views like this which really stop this city from moving forward towards a future London built around people and not cars - cars which are mostly travelling distances which can walked or cycled and often with only one occupant (the driver). Cars are a hugely inefficient way for people to travel in a built-up, densely populated city such as London. And yes, a bicycle is a vehicle, and one which is allowed to use roads by right, whereas driving is a privilege which is only permitted on roads under the terms of licence. And we ALL pay for the roads, whether we walk, use the bus cycle or drive. Time to make better use of road space methinks. Enough of selfish drivers sitting in queues behind other selfish drivers and taking up all the space and polluting our air!
The London Cycling Campaign has local branches in every borough and organises lots of social rides and activities that improve health and wellbeing. It also campaigns for safer cycling facilities as that is one reason that many people don't participate and end up isolated behind the wheel.
Just two points here - some of us can’t cycle due to disability, and our public transport although good is not as accessible as it could be, although it is getting better, so more cycleways at the expense of other road users is not the only answer. I think there is a case for cycles to be registered and pay a small charge to use roads, the same as cars lorries and busses etc. It will also help to crack down on poor driving & cycling if road users who broke the rules faced real consequences.
We don't have enough space to imitate the Dutch. Solutions that work overseas don't necessarily work here. We are very densely populated and overcrowded.
Sorry but I do not relish the prospect of any more cyclists on our roads - and pavements. I risk my life every time I cross the road at a red light. Not only to cyclists jump red lights at top speeds, but they also cycle the wrong way, so they catch you unawares. If you challenge them, they can become very abusive.
Once, a cyclist was blocking the pedestrian crossing when I was trying to cross the road. I said, "Excuse me?" Instead of letting me pass, she deliberately cycled INTO me - bump-bump-bump - and then hollered a torrent of abuse behind her. I couldn't believe I got assaulted like that just for trying to cross the road!
Another time, I witnessed a Deliveroo cyclist collide with two elderly gentlemen who were crossing the road. They asked the cyclist if he was aware that he was cycling the wrong way on a one-way street. He replied, "Yes," and then carried on cycling, without so much as an apology! He was cycling with a phone in one hand.
It is infuriating to see roomy cycle lanes lying unused while cyclists insist on wobbling along on narrow, crowded pavements.
I agree that fewer people should drive. However, I would suggest that walking is both more physically demanding and also safer than cycling in London. More people should be using the trains and walking to/from stations. Perhaps the Mayor could reduce train fares to tempt people away from the buses.
I agree that cyclists should be registered. I'd also like to see a bobby at a red light giving out tickets once in a while, not just to catch cyclists but also to catch vehicles that straddle the pedestrian crossing, blocking people who are trying to cross the road.
If you have long term conditions, disabilties or are visiting GP to address current illness it may be that some forms of transport and exercise are not accessible. Not all illness is due to a lack of exercise! There are obvious connections, however - obesity and its links to heart disease, diabetes etc. However, sometimes an injury or illness prevents exercise, or medications cause weight gain. It is often a long haul to recover physical and mental fitness, so support, encouragement, motivational approaches and small gains in wellbeing are very much to be valued as part of health and social care
It's not just about being more active but being more engaged. I am part of a small gardening project run in conjunction with my GP practice and the benefits are in no way about ease of getting there, which is not difficult in a physical sense as the practice is close by. It is beneficial in that it provides incentive in a safe setting for people to get out. It provides interest, social contact, involvement, commitement, physical exercise, mental stimulation, better communications with people, a distraction from pain and illness and a better relationship with the GP practice staff. It iis abosolutley not backward thinking. Not everyone has the mental or physical capacity to get out, motivate themselves, follow through with plans. If you have severe anxiety, no network of cycle lanes is going to be of help as you may not be able to leave the house or travel very far. If you have difficulty with mobility, cycle lanes are worse than useless for you at this time. I can't use them as I can't use a bike. However, having a place to go at a prescribed time, regularly and with familiar people may provide a safe environment to give patients the confidence to expand their abilities, improve their mental, self esteem etc.
I think it is a great idea.
I had heard of it but not in any detail. Funding will be key, as well as creative use of existing community facilities like schools, universities etc at times when they are not being used by paying students. It will also rely on GPs and other healthcare professionals having the time to talk through what people are doing or have tried already to see if they can build on it rather than make assumptions. Generally it’s moving in a positive direction though.
Hi Karin49 and thanks for sharing your views.
The majority of activities that the social prescriber(or link-worker) refers someone to are free to them to attend, for example exercise or gardening clubs. Others may make a small charge (for materials) for example. Many social prescribing projects are funded by the NHS, local authority or charities to provide services.
What sort of health, wellbeing and social conditions and issues do you think might benefit the most from a social prescribing approach?
Talk London
It is a brilliant idea.
It has the potential to give people an interest, a sense of purpose, confidence in themselves and their ability, a new perspective and a social aspect which will help people make important connections and alleviate alienation. It has the potential to promote self-reliabilty and sufficiency and present people with opportunities they may be unaware of.
It is patronising, arrogant, offensive and designed to ensure fewer people get the treatment they need.
MattKnight1986 - I gather that the quantitative evidence is in short supply. I would absolutely agree with Martyn27uk that this essentially medicalises social issues, and that GPs do not need the extra workload. By all means have information located in GP surgeries, as is it often is, and ensure that GPs advise patients on what is or is not safe and suitable for them to try. But there should be no prescribing for psychosocial problems, and the NHS should not be funding social prescribing. Other essential services are being cut.
One possible serious ill-effect of social prescribing is that they could worsen the situation of people with psychosocial issues. For example, the counselling industry professional training churns out pracitioners who believe that people should accept responsibility for the position they are in. This would be fine, if approached carefully. But most counsellors are unable to discern between this and blaming the victim, and simply do the latter. In this world-view, realities of life such as the failings of Universal Credit or the poverty trap are meaningless. Clients just need to accept responsibility for putting themselves in that position, and step out of it.
Most counsellors seem to have no understanding of the reality of the lives of the people who would be sent their way by social prescribing, and would seriously undermine their wellbeing because of their limited experiences, cultural bias, and propensity to blame the victim. Social prescribing could be a minefield.
I have yet to meet a single front line NHS doctor who thinks this is a good idea.
By all means allow those who need access to such services to receive them but "medicalising" what are essentially social issues will pile yet more work onto an already overstretched Primary Care sector.
GPs, especially those in partnerships, are taking early retirement in droves. Why? Take your pick from 12-13 hour working days, lack of time to spend with their families, essentially meaningless annual appraisals and revalidation, the changes to pension regulations whereby retiring early aged 55-57 is the only viable option, "Quality Control" inspections carried out by unqualifed staff with no experience of front-line medical care and eye-watering increases in insurance premiums.
As for the 5000 "new" GPs who are going to arrive like the 7th Cavalry and save the day.... dream on. The last thing any medical student in training wants to do now is train as a GP.
We should be diverting workload away from Primary Care, not towards it.
I couldn't disagree more strongly.
There are a plethora pof trials out there demonstrating that social prescribing is incredibly effective at improving health and wellbeing and reducing the need for medical intervention, including hospital admissions.
GPs and other primary care providers are not, and should not, exist purely to fix acute aimlents of the population. This approach is, I believe, what has caused the outflux of GPs from practice since they are always fire-fighting. Likewise, this is increasing the demand for acute secondary services.
Social prescribing shifts the focus from illness to wellness, reducing the likelihood of people requiring more intense, costly and dangerous intervention.
So long as the social prescription is for evidence-based activities that promote overall wellness, they should absolutely be encouraged.
Social Prescribing's main purpose is to address the non-medical causes for loss of wellbeing and divert non-clinical problems away from GPs and towards social support in various forms so it is precisely opposite to what you say. GPs are not asked to deliver social prescribing but rather to ensure that patients are referred helpfully to the support they need outside of the GP clinic
Another loony idea from well meaning do gooders. At this stage concentration should be on helping and improving existing structures and encouraging people to stand on their own two feet. As one of the problems in London is the surfeit of non English speakers I strongly believe that any addition taxpayer initiatives (I hate that word) are concentrated on ensuring everyone learns to speak English.
I do not think this idea comes from well-meaning do-gooders, though they will be the ones volunteering, or being paid to tell people which leaflet to pick up and read. It surely comes from ill-meaning folk who are tasked with making sure fewer people get the diagnoses and treatments they need.
As Vice Chair of Hounslow Community Network, I'm working with the local Clinical Commissioning Group (NHS) and Council to help integrate heatlh, social care and the voluntary sector; one of our main new focusses is on social prescribing and how we can improve and expand on what is currently available in our borough.
It's a fantastic idea and I think this is the way forward. Many medical problems are exacerbated by underlying social problems and the stress caused by these. Referral to support groups, relevant third sector organisations, sports clubs, book clubs, self help groups, volunteer work, etc is an excellent idea. At the core of many health problems are depression, financial problems, bad diet, lack of exercise and lonliness. It's hard to overcome many of these issues by yourselves and it can feel overwhelming to know where to start, especially if you are depressed. Social support really could be the key. I think there would potentially be many people willing to volunteer for such schemes as well who would also benefit from having a purpose and a chance to offer their time, knowledge and skills to others in a meaningful way. I am not retired but I would be happy to give an hour or two a week to help someone in need - even if just to pop in to see someone who needs befriending and have a chat over a cuppa. This could offer a lot of people hope.
Yes, there is a befriending service. I thought the same way as you and had a go at social prescribing; but now think it should be complemented by other means of 'advertising' services. As you say, societal problems cause a lot of ill health.
The last thing I would want if I was in a book club or interest-group would be to have people referred to join it, especially as this is a way of redirecting people who need proper treatment away from the NHS. By all means ensure that information about local support groups, free or genuinely affordable activities and classes (so rare these days), and physical activities opportunities is available in the right places. But don't patronise people by calling it 'social prescribing' and don't use it to replace proper medical care. So much in the voluntary sector is parasitical, just anothery way of colonising those defined as 'needy' in one way or another.
I hadn't heard the term social prescribing but now that it's been explained I fully support the concept.
It's very easy to feel isolated in London. When I was living and working in London full-time I was fortunate to join a running club and two swimming clubs and the relationships that built up formed a huge part of my life.
Now I'm retired, I spend most of my time outside London. I have two allotments and they form a huge part of my life. Unfortunatley there's not a lot of space for allotments in inner London.
As a young student, many years ago, I had a holiday job driving a minibus which collected elderly housebound people and took them to a day-centre for a meal and a chat. It made a huge difference to those old people.
So, I would support most investments or activity that encourages sober social contact between Londoners. I say "sober" because I exclude drinking in pubs as a good idea.
Peter Maughan
But should it be prescribed by GPs? Paid for by the NHS?
Well, I think that if GPs and the NHS were able to refer patients to already existing organisations for social support, instead of other options such as prescribing drugs, then social prescribing might possibly reduce costs to the NHS, as well as being the better option for the patient.
I have heard of it and I think it's a great idea however unless businesses accept this prescription with equal weight to medicinal prescribing then lots of people will struggle to get the benefits from social prescribing as they can't get the requisite time off work if required
i think this is a great idea - it helps foster a sense of community, as well as helping to improve people's mental health. Sometimes people need a push in order to do things, and this is a great way to achieve that. Everyone should get out of the house more - even if they don't want to!
People don't always want a sense of community. Also the conditions in which this sense of community can thrive and grow are being planned out of very many areas by local government 'place makers'. Instead of community design coming from the community, it is applied top down, accompanied by 'consultations' in which local people cannot actually influence anything. So the quiet, uncrowded, streets that a community needs for those 'unplanned interactions' that are vital to a sense of community are replaced by gentrified streets, streets thick with crowds and attractions. Local services and 'amenity' shops are driven out by upmarket businesses featuring cocktail bars amongst the designer garments. If you want to foster community and community support, make local government protect it at the fundamental level of the streets that people live on.
Funding is not a problem, costs just to be added to Council Tax locally.
I think it is an excellent idea and well worth implementing across the country.
GP's are already under considerable pressure with the amount of people on their books, so perhaps the person needing help using Social Prescribing could be contacted by someone or visited on the recommendation of that GP.
Hospitals are also under great pressure, so perhaps they would also use the same idea of someone contacting that person in need.
Somehow all people offering classes of whatever category in their local area need to be aware of Social Prescribing and sign to it so bringing awareness of what they can offer.
I think more needs to be done to encourage people of all ages to benefit from cycling and walking in their local parks.
Asking these people who would benefit from Social Prescribing to volunteer. There are so many areas that could benefit from more volunteers. There are unloved grounds within train stations that would benefit from volunteers helping to develop wild flower areas.
You know, for many people just one two-hour class of whatever category cost as much as one third of their weekly income. Walking in local parks? Only when the local park isn't too full of commercial events or concerts, or fenced-off so the grass can regenerate after months of summer and winter events. But in reality there is already a huge range of activities available in most areas, as there always have been. Look in the local library, anywhere with a community noticeboard, look in cafe and corner shop windows, pick up those leaflets in your GP surgery, look online for what is on in your area. Just don't let government re-package all this activity and use it to cut down on essential proper diagnostics and referals for appropriate medical help. I was offered something similar by my GP, who insisted that the NHS no longer funds the medical help that I need. Instead he referred me to a sports centre where staff were unwilling to have me because they were neither qualified nor insured for dealing with someone with my disability. I subsequently found out that the NHS does indeed offer the appropriate service at a local hospital. GPs have been tasked with reducing the numbers of referals they make.
Sounds like Occupational Therapy to me.
Of course if we lived the lives our bodies are designed for, activities wouldn’t need to be prescribed.
If charities are expected to deliver these activities, then they need to be adequately funded
On the face of it this sounds like a good idea but would it work - before anyone could be “prescribed” the activity must exist, the diversity of experience and schemes would be immense as would the admin to support it. In our risk averse world is it sensible to fund this while children’s playgrounds are uninsurable ( and thus close) due to risk of legal action?
The problem I always find is that these type of things are scheduled for the morning or between office hours. There may be an assumption that working people have no need for this.
I know I do as I work full time but feel lonely and idolatis the rest of the time. I do have a hobby but itsi just not enough to make me feel good.
*isolated
I didn't know about it and I would be happy to take part as I feel quite isolated in London. Living here is really hard.
There are endless things to join in with in London. Poetry groups, philosophy groups, people who walk at weekends or visit museums together. People who play chess. People who run together at weekends. Loads of volunteering opportunities. Book clubs. Check out your local library, ask if they have leaflets and lists of local community groups and volunteering oppotunities. Look out for shops or cafes that have notices in the windows. If you don't find anything, look online. Or start something up yourself. People to go to the theatre with, find a dance class. Check out the LETS website for local skills exchanges. E.g. Kutlets socials in Kingston, take items to trade and food to share, pot-luck. LETS is Local Exchange Trading Scheme, you can offer a service or skill, find community activities, and so-on. Just one of the ways of finding people and networks, things to do and join in with.
I know how to shift people's physiology to move them on from a whole range of issues with a combination of motor skills exercises, sound and vision therapy. The fastest win for any community is to improve motor skills (see the work of the Slovenians with their SLOfit programme or the Japanese with their daily Radio PE programme) , but in order to do that the community sports leaders need to be trained in how physiology impacts on development, sound and vision processing and mental health. There is no money for this and/or sports coaches have their own agenda.... Likewise politicians and Doctors also are very ignorant of the needs of human development in the UK. Therefore I think that social prescribing is nice, it is a good idea, it is undoubtedly good to acknowledge that community projects are good for everyone's health - but when I have worked with long-term unemployed for example they often have complex needs that need to be sorted out, just keeping them busy gets them out of Doctors' surgeries but it does not deal with their real issues and move them on to a state of coherent mental and physical health.
Ihave not heard of this expression before, but it seems a good idea. One of the churches in this area hosts activities similar to those decribed, e.g. keep fit for over 60s, pilates, walking football, ramblers, woodwork classes etc. It makes for social interaction as well as physical fitness.
I have heard of social prescribing in the media recently, possibly because of this draft report but I can't recall exactly when. I've had a quick look at the report and my thoughts are:
- It's great that it is being recognised that "external" things such as work, housing issues etc. can impact on health both in the short and long term.
- However the social prescribing is delivered, it will be crucial to make sure ALL GPs are aware of it so that no one still going to their GP for these sorts of issues misses out.
- It will also be crucial to advertise it to the public as much as possible in order that people (where relevant!) stop going to their GPs and therefore ease the pressure on those medical services.
- These services will need to be properly funded so that people go along for a few months, only then to find that the service that was helping/working for them has had to close due to lack of funding and that the individual is back where they started.
I'll be interested to hear more about this! If it was offered/available, I would definitely use this service.
All this has always been there. I don't believe for a minute that there are hordes of patients clogging up GP surgeries and taking up services unneccesarily because all they really need is some social interaction and a few interests, a bit more physical activity, or an unaffordable Italian cookery class. This is just a way of misdirecting people who genuinely need proper referals and medical help. They may also benefit from more social interaction, but it is wrong to waste money on paying people to round up all the locally available activities for GPs to 'prescribe' to patients. This information has always been available in libraries, adult education centres, community centres, loca cafe windows, churches and so-on. Forget the sports centres - they simply do not give out information and do not welcome anyone who is not young and fit who turns up looking for classes or exercises. It is good to get free classes at them, but they are rarely insured or trained to offer what is actuallyneeded.
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