Update

How can social prescribing help heart patients?

Social prescribing schemes around the country recently received a government funding boost. But what is social prescribing, and can it improve your patients’ health and wellbeing?


28 September 2018, by Siobhan Chan

Social prescribing is in the spotlight following the Department of Health and Social Care’s recent announcement of a £4.5m funding boost.

Twenty-three schemes across England will receive the funding. These include programmes to support people who visit their GP or A&E very frequently or are socially isolated.

Nearly half of the 211 clinical commissioning groups (CCGs) in England are investing in social prescribing programmes, according to NHS England. And social prescribing can ease workload pressures on GPs, according to NHS England’s General Practice Development Plan.

A recent Public Health Wales Primary Care Hub report described ‘wide professional and political support in Wales’ for social prescribing. Some schemes in Northern Ireland are being expanded, and social prescribing has been acknowledged as a way for people to manage their mental health by the Scottish Government in its Mental Health strategy.

So what is social prescribing, and how can it help you and your patients?

What is social prescribing?

In social prescribing, GPs, secondary care professionals and social care workers can refer patients to non-clinical community services to improve health and wellbeing.

In many social prescription programmes, patients meet a ‘link worker’ who assesses their needs and suggests the most useful services or resources.

This can include activities like art classes, gardening clubs and walking groups, which can benefit people who are socially isolated or have anxiety. Some schemes put people in touch with services that can help with wider social issues, such as housing and legal advice organisations.

One of the longest-running social prescribing programmes, the Bromley-by-Bow Centre in London, offers horticulture groups, one-on-one money advice sessions and a weight-management service.

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What’s the evidence that it makes a difference?

Evaluations of social prescription services tend to show good results for patient and professional satisfaction. Patients report better management of their conditions and associated social issues.

For example, patients with the Ways to Wellness scheme in Newcastle reported improved self-confidence, healthier eating and increased physical activity. And patients enrolled on the scheme incurred 11% lower hospital costs in 2017/18 compared with the control group.

A review of social prescribing by Bristol CCG found that social prescribing schemes can ease patients’ anxiety levels and improve their feelings about quality of life.1

An arts scheme in Cambridge found that 76% of participants reported an increase in wellbeing, 71% reported a decrease in anxiety and 73% reported a decrease in depression.

Larger-scale reviews of these evaluations have been less certain about their benefits. A systematic review of 15 programmes published in 2017 found that “current evidence fails to provide sufficient detail to judge either success or value for money”, noting that many of the evaluations rely on self-reported findings.2

Nevertheless, a 2017 review by the University of Westminster found that on average there was a 28% reduction in demand for GP services following referral to a social prescription scheme, and 24% fewer A&E attendances, but acknowledged the need for more research in this area.3

Social prescribing for heart patients

Patients with long-term conditions such as heart and circulatory diseases may benefit from the social inclusion and increased emotional support that social prescribing can bring.

GPs in Newham can also refer patients at risk of diabetes or cardiovascular disease onto a 24-week programme offering a wide range of tailored physical activities. The initiative, funded by Newham CCG, puts patients in touch with lifestyle advisers who provide them with guidance and signpost them to fitness-based support.

 Screenshot of HealthUnlocked signup page for high blood pressure email journey

The BHF is currently developing a social prescribing service through HealthUnlocked, an online forum where patients share their experiences with a community of people in similar circumstances and support one another.

GPs will be able to signpost patients to a curated directory of useful resources on HealthUnlocked, including a 12-week ‘email journey’ for newly diagnosed patients to help them better understand and manage their condition.

Explore the HealthUnlocked site and find out more about the patient email journey.

Find out more

References

1. Kimberlee, R. (2013) Developing a social prescribing approach for Bristol. Project Report. Bristol Health & Wellbeing Board, UK. Available from: http://eprints.uwe.ac.uk/23221

2. Bickerdike L, Booth A, Wilson PM, et al (2017) Social prescribing: less rhetoric and more reality. A systematic review of the evidence. BMJ Open 2017;7:e013384. https://bmjopen.bmj.com/content/7/4/e013384.info

3. Polley M, Bertotti M, Kimberlee R et al (2017) A review of the evidence assessing impact of social prescribing on healthcare demand and cost implications. University of Westminster. https://www.westminster.ac.uk/file/113316/download (PDF)

4. Moffatt S, Steer M, Lawson S, et al Link Worker social prescribing to improve health and well-being for people with long-term conditions: qualitative study of service user perceptions. BMJ Open 2017;7:e015203. dx.doi.org/10.1136/bmjopen-2016-015203