Social Prescribing – what are the practical issues for NHS England

Social prescribing enables GPs, nurses and other primary care professionals to refer people to a range of local, non-clinical services.  the KingsFund have a helpful article here
I am the Founder and CEO of BriteLives.  BriteLives is about providing activities and connections that help people avoid the NHS and its expensive statutory services. For us, it’s all about staying fit and well.  If someone does become unwell then, of course, they should go and see someone at their primary care practice.  But there are other options that the NHS could offer and signpost.
A comparison between current models of prescribing and treatment in primary care and how social prescribing might work shows some stark practical challenges.
Let’s take the example of someone feeling depressed, it’s common mental health issue that people feel increasingly able to acknowledge.   A doctor could prescribe antidepressants, (64.7 million were prescribed in 2016, 31million in 2006, that’s106% growth)  in fact, the Pharmaceutical companies profits are predicated on this behaviour.
It’s easy for the GP to do so, the workflow is found in the GP System, the Electronic Prescribing System,  the paperwork of the NHS and its Green Prescriptions forms, the Pharmacy systems and NHS payment systems.  All pretty much automatic and easy for the GP and patient to follow.
But, if the Doctor wanted to refer the patient to a BriteLives service; like a wellbeing course such as  http://www.britelives.com/listings/growing-wellbeing-6-week-course/ (this is a practical course that helps people address their depression without the recourse to drugs).   How might the Doctor go about that?
  • There is no listing of local services in the GP system.
  • No method of auto referral, it’s “not at the touch of a button”.
  • No reporting system telling the service provider someone is on the way
  • Not even a referral letter that can be printed or emailed
  • No Payment method for the service provider.
  • No system to make sure the final payment is only taken on the delivery of the service.
  • No Copayment system should the patient want to do more or add services
  • No way of innovating new ideas such as:
    • A reward split, GP pays £20 for service,
      • £1 goes to GP to encourage use of non-pharma
      • £15 goes to the provider for the service
      • £4 goes to the patient for completing the course (it can be seen as covering transport costs or the like if you don’t like the “bribe” aspect of this)
I believe that NHS England needs to become serious about centring social prescribing care around the individual and the local community. Developing an effective social prescribing policy and strategy would be a good start.  At present, there isn’t one and progress will be slow.

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