Social prescribing

Those on minimal incomes cannot afford those reduced rates, and adult classes cost a fortune these days. I was referred by a GP to a sports centre, but the staff were neither willing nor trained to have someone with my disability in the building. The NHS has totally stopped local GP funding for early intervention services, such as for dieticians, yet government claims that the NHS will focus on prevention. The opposite is true - GPs are bending over backwards to avoid actually referring patients for essential tests or hospital based services.  All this nonsense about social prescribing is not going to help all those people who genuinely need medical help and are not going to get it until it is much too late because they have been 'social prescribed'  adult education classes or whatever.  There may be a need to get the information on what is available locally to the right places. It used to be found in community centres, in libraries, in ordinary corner shop or cafe windows and in adult education centres. Even on primary school noticeboards for parents to see.  Tesco used to have community notice boards near their entrances or exits.  Didn't some post offices have community noticeboards at one time?  Now we have hardly any libraries, community centres and so-on. And so many people are not online and don't use computers, so cannot find local activities by looking online.  By all means get information flow organised, but stop this arrant nonsense about social prescribing.

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. 

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. 

*isolated

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. 

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.

But should it be prescribed by GPs? Paid for by the NHS?  

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 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. 

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.

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.

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!