Social prescribing is becoming an increasingly popular term but what does it mean, what are the benefits and just how are we going to make this widespread in the healthcare system?
The King’s Fund put it succinctly when they describe social prescribing as ‘enabling GPs, nurses and other primary care professionals to refer people to a range of local, non-clinical services’.
Essentially, social prescribing looks further than a patient’s interaction with the healthcare system on one occasion and considers social, economic and environmental factors to enable individuals to access a more sustainable, long-term way to improve their health in the community. In action, social prescribing enables healthcare professionals to refer to a range of community and third sector, non-clinical services.
From a medicines optimisation standpoint, social prescribing has been shown to combat unnecessary prescribing resulting in reduced prescriptions, alongside reduced GP appointments from frequent attenders (Jones and Lynch, 2018).
There is a real synergy between the benefits of social prescribing and the potential harmful side effects of polypharmacy – where people are prescribed many different medicines for one or more health conditions.
Due to a range of factors, the number of people taking five or more medicines has quadrupled from 12% to 49% and there has been a steady but noticeable increase in the number of medicines taken by older people in last two decades. A person taking 10 or more medicines is 300% more likely to be admitted to hospital and 6.5% of hospital admissions are for adverse effects of medicines; this rises to 17% in the over 65 age group. With the way medicines usage has progressed, the risk of the unintended or harmful side effects and errors is much greater.
Social prescribing offers a potential alternative to some medicines and could enable deprescribing to patients effected by polypharmacy.
A brand new NHS England group: the English Deprescribing Network (EDeN), define deprescribing as a collaborative process, which is patient-centric and focuses on a shared decision making process with the patient / carer. This approach ensures the safe and effective withdrawal of medicines where necessary.
The view that social prescribing will be useful in paving the way for medicines optimisation, such as deprescribing, is supported by Secretary of State, Matt Hancock who in an interview said: “Evidence has shown the potential benefits of approaches like social prescribing, which addresses people’s physical and mental wellbeing and has been shown to both improve patients’ quality of life and reduce pressure on other NHS services.”
NHS England’s commitment to social prescribing is evidenced through the option for new Primary Care Networks to employ a Social Prescribing Link Worker for their area. These posts are funded entirely by NHS England and is a tactic outlined in the NHS Long Term Plan.
Spreading social prescribing at a large scale
It sounds great, but how can social prescribing at a large scale hit the ground running? Social prescribing isn’t new and there are lots of different models for social prescribing, but in order for it to work there needs to be the right foundations and joined up working within the local system.
That’s why we think it’s important to use our position to work in consultation with key groups within the system and the public to investigate and identify local social prescribing areas of excellence, the gaps and unmet needs. Understanding the landscape will help us to explore the key components to the most effective models for social prescribing, which in effect could be adopted and spread across the country.
For medicines optimisation, social prescribing is one of many tools that can be used to address inappropriate medicines prescribing and is definitely an area we want to investigate further as an AHSN.
Social prescribing scoping tool
Work is currently being undertaken by the East Midlands AHSN to develop a social prescribing scoping tool, which aims to map out and explore the different social prescribing components that are active in different areas, to allow benchmarking and improve current provisions. Our aim is to develop this using data from the East Midlands as a starting point, with a long-term goal of providing access to other regions via AHSNs.
As with all of our projects, we work with health partners to establish priorities and local challenges. For this reason we are hosting a Social Prescribing Networking Event on 23 May 2019, aimed at East Midlands’ wide providers of social prescribing, or those planning to deliver this service, to inform, inspire and network as well as feed in to this scoping exercise. You can book on to this event here.
If you’re interested in our medicines optimisation portfolio of projects, you can learn more on our website.