Don’t be surprised if the next time you visit the GP because you’re feeling anxious or depressed, you’re advised to join a choir, do a parkrun or even learn how to model clay instead of being sent home with a prescription for medication. Social prescribing is when doctors or other healthcare professionals refer people to non-clinical services. The schemes can involve a whole host of different activities, including gardening clubs, choirs, dance classes, volunteering, art activities, group learning and befriending services, and are often run by voluntary or community organisations.
It’s the current buzz phrase in healthcare and part of a more holistic approach, which recognises that people’s health can be determined as much by their environment and social factors as any ailments. “Many people who come through the surgery door have problems that can’t be solved by pills, surgery or medical interventions alone. By addressing these, social prescribing empowers people to take control of their health and wellbeing,” explains GP Dr Michael Dixon OBE, one of the earliest pioneers of social prescribing. As National Clinical Lead for Social Prescription (NHS England), he is responsible for ensuring all GP practices offer such a service by 2023.
A growing body of evidence suggests that social prescribing can help to lift depression and ease anxiety, as well as make people who are lonely, isolated or have a chronic health problem feel more connected. “The great thing is its flexibility,” comments GP Professor Sir Sam Everington OBE, a social-prescribing trailblazer, whose London-based Healthy Living Centre, with its café, gardens and myriad activity groups, opened more than 20 years ago and is now a blueprint for successful social-prescribing services.
In recent years, doctors and patients have been limited to ten-minute consultations that ended with a prescription as the answer. “With social prescribing, there are 101 different potential solutions,” Professor Everington says.
The ‘prescription’ could be any number of things: support to help make life changes; encouragement to sign up for a course; help to find a class, group or other activity; or help accessing advice on practical issues such as money, housing or legal problems. If you and/or your GP think you would benefit from a social prescription, you will be referred to a non-medical go-between – variously called a link worker, health navigator, health connector or health trainer – who gets to know you, gives you time to focus on what matters to you and helps you draw up an action plan tailored to your needs.
HELPING YOU HELP YOURSELF
Although touted as the next big thing, social prescribing is in many ways a return to an older model of healthcare that existed at the start of the NHS, when we knew our GPs and they knew us and our families. As Frome GP Dr Helen Kingston – another leading light in the social-prescribing movement – observes: “It is all about connecting with others – something we’ve lost in an era of endlessly staring at our mobile phones. It turns the conversation around from what the doctor can do to fix you to what you – with support – can achieve yourself.”
While a few enlightened GPs have been offering it for years, the current agenda puts this on a more organised footing. As outlined in the NHS Long Term Plan, the government is determined to make social prescribing more accessible, with the promise of a £4.5m cash injection to fund social-prescribing schemes. The National Academy for Social Prescribing was formed last year to support GPs and other frontline health workers, and there are now nine social-prescribing regional networks working together to share best practice.
People who have experienced social prescribing speak of it glowingly. According to research from the University of Westminster, it is linked with a 28 per cent fall in visits to the GP, fewer A&E attendances and also fewer referrals to outpatient units. However, it’s early days and it’s likely that its full impact will not be felt for some years. “Being involved in the community gives life meaning and purpose,” explains research leader Dr Marie Polley, co-chair of The Social Prescribing Network. “People report an upturn in confidence and less depression and anxiety. Aches and pains often get better or become more manageable.” And surely that has to be a better option than a pill for every ill.
ON PRESCRIPTION… gardening
July 2020 will see the grand opening of the Royal Horticultural Society’s first new garden in nearly two decades: RHS Garden Bridgewater in Salford, Greater Manchester. And some of the volunteers (left) helping to create the gardens are part of a new social-prescribing scheme. Lack of gardening experience or physical ability are no barrier to getting involved, and activities include everything from weeding and planting to digging and deadheading. As well as the mindful benefits of gardening, RHS therapeutic gardener Ozichi Brewster (above) believes people benefit from contributing to such a project by seeing the fruits of their labours: “Our referrals can see when the hellebores spring up in the future and know they planted them. It makes people feel they’re part of a community.”
ON PRESCRIPTION… museums
While ‘prescriptions’ for art, exercise and green spaces are more widely known, museums and galleries can also offer a valuable opportunity for social prescribing, says Professor Helen Chatterjee from University College London. She led Museums on Prescription, a project that brought together museums and referral agencies, such as Age UK, to help older people at risk of social isolation. Activities included museum object handling, crafts and behind-the-scenes tours – and participants reported an increased sense of belonging and improved quality of life. “Many of the people weren’t leaving their homes very often, but the weekly museum session gave them a purpose,” Professor Chatterjee says. For more antidotes to loneliness, go to countryliving.com/uk.
ADDITIONAL RESEARCH BY KATE LANGRISH. PHOTOGRAPHS BY LISA COHEN; GETTY IMAGES ■