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Complementary session looking at social prescribing

Complementary session looking at social prescribing

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Debbie Delves

The College of Podiatry was pleased to be able to welcome Dr Mike Dixon, Chair of the College of Medicine and Integrated Health, to lead this session. Dr Dixon is additionally the National Clinical Lead for Social Prescription for NHS England.

Social prescribing looks to be the new buzz word in the next year or two and will be of increasing importance in the future. It is a way of linking patients in primary care with sources of support within the community. It provides GPs with a non-medical referral option that can operate alongside existing treatments to improve health and wellbeing. This popular session de-mystified this concept, which the Prime Minister and Simon Stevens of NHS England are both keen to roll out.

Around 20% of patients have social problems in one form or another, from loneliness to housing problems. In addition, 2-3% of the population are considered ‘high hospital users’. Use of social prescribing in this group has been found to reduce hospital use by 20%, rising to a 50% reduction in those over 80 years old. Social prescribing has also been shown to convert up to a third of type 2 diabetes and pre-diabetes patients to a non-diabetic state.

Social prescribing is not just about telling people what they need to do to be healthy. It is about supporting the process to ensure life-changing behaviours are maintained. 

The difference between signposting and social prescription is the key role played by link workers, who is fundamental in changing lifestyles and maintaining motivation. They support the patient until the social prescription is fully activated, looking at the process from the patient perspective, identifying blockers to behaviour change and working through it.

Patients tend to move through four levels of engagement:

Level 1 – where they are disengaged and overwhelmed

Level 2 – where they become aware but are struggling 

Level 3 – where they begin to take action

Level 4 – where they are able to maintain their behaviour and start pushing themselves further.

The types of activities within social prescription are broad and varied, from giving advice about housing and benefits, to exercise or arts classes, and being involved in volunteer activities; things that will make a difference to people’s lives. For example, gardening increases life expectancy by five years, and we heard from Julia Bradbury about the mental health benefits of walking. 

Currently, only 14 of the 220 CCGs provide social prescription, despite evidence that it reduces GP and hospital appointments by 20%. Universal role out is anticipated by 2023.

Many doctors have been involved in social prescription for some years, but how can we get more involved? We often see patients who are in need of social prescription, but we do not know where to direct them. Podiatrists can play their part by getting to know their local link worker and ensuring they know what podiatrists do. It is anticipated that in the future there will be direct access to these link workers, without the requirement to go through the GP. 

Members attending this session found it most interesting and looked forward to playing an active role in improving the quality of their patients’ lives through this initiative.