Investing in a social prescribing approach could take pressure off formal healthcare services, as well as benefit individuals and communities, a panel of charity and social enterprise representatives say.

Speaking at an event hosted by the Royal Society of Edinburgh, Benedict Lejac, the author of a report commissioned by the College into the potential role of social prescribing in Scotland, believes social prescribing can contribute toward a more citizen-centred recovery from the pandemic.

Mr Lejac, who works for Support in Mind Scotland, notes in the report that up to 50% of GP appointments focus on non-medical issues, such as social isolation, financial struggles, and bereavement, which he argues could be handled better within the community.

One study in the report said 78% of GPs had prescribed antidepressants when they would rather offer an alternative treatment, but other approaches were simply not available.

A social-prescribing approach seeks to enable GPs and other primary health care workers to refer patients to local non-medical services, such as community hubs, befrienders services or local walking projects.

A 2019 inquiry by the Scottish Parliament’s Health and Sport Committee found that social prescribing had considerable potential for preventing long-term conditions and dependence on pharmaceutical prescriptions, as well as alleviating depression and anxiety.

But barriers such as funding and awareness have held back a national roll out, according to both the report and the speakers.

Mr Lejac said that even in areas with well established social prescribing arrangements, awareness was still lacking, extending right up to primary health care; he argues that much is still to be done in increasining engagement at every level.

They highlight the intense pressure on health services due to delayed medical procedures and appointments during covid-19, as well as growing mental health issues fuelled by the pandemic, and urged ministers and NHS leaders to invest in social prescribing locally and nationally.

Hugh Asher, co-founder of Darach Social Croft, a social enterprise that uses natural resources to provide social support, promote wellbeing, and improve psychological and emotional functioning, said at this week’s event: “Social prescribing should be seen as an investment, not a cost.

“There’s a big opportunity to provide early intervention, and to prevent deterioration.

“Focus on the factors that support good health and wellbeing, rather than waiting for people to become unwell.

“Social prescribing has a lot to offer in terms of bridging gaps and supporting transitions to services, rather than just signposting.”

The key to redirecting funding away from clinical settings into social prescribing organisations is to demonstrate the positive impact this approach is already having, according to Cameron MacFarlane of the Health and Social Care ALLIANCE Scotland.

Mr MacFarlane, who is the Community Engagement Manager of the ALLIANCE-led ALISS programme, a national database of community organisations funded by the Scottish government, said that those with lived experience, especially those with mental health problems and learning disabilities, can demonstrate the value that already exists within communities and the potential more funding could unlock.

Hugh Asher added that this would likely be a slow process, requiring pilot studies and greater regulation of the sector, and that any future evaluation should be ‘outcome-focused rather than output-focused’ so the true value of non-clinical interventions can be seen.

Social prescribing has been advocated and used at least since the 1990s in Scotland, and has become more widely used with the establishment of community links workers who provide a connection between primary health care teams and organisations.

Speaking at the event, Clare Cook, Regional Manager of SPRING Social Prescribing, outlined the important role of links workers and how pandemic changes in referral routes can be continued to widen access to services going forward.

She said that the eight community-led organisations she manages across Scotland are rooted within the heart of their local communities and that allowing pharmacists, housing associations and other educational and local professionals to refer people to the services allowed links workers to target those hardest to reach.

Rounding off the discussion, meeting chair and Enable Group CEO Theresa Shearer, suggested that recognition of social prescribing as an option is growing:

“Social prescribing is an effective way to support the changes with our demographics in Scotland, and how to support individuals to have the best lives they can.

“To take the spend that is focused on clinical settings and ensure we are making the most of our community-based assets.

“Perhaps we are starting to see a change in the tide in that recognition that some things can be dealt with better in the community.”

 

Read more: Over half of Scots fear lack of mental health support; Review: Has covid changed voluntary health forever?

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