Having been on heavy doses of medication for my mental health for most of my life, I know the impact it can have and how much it takes from the person’s ability to function and thrive in life. I never knew what each specific medicine was for, or the side-effects of each one, nor the interaction being on the cocktail of such medication would impact me (both positively and negatively). But having just returned from the launch of the Beyond Pills Campaign, I am feeling inspired and positive about the future of social prescribing and the beauty of connecting with the community using an asset-based approach.
The Beyond Pills Campaign launched by the College of Medicine calls for Government intervention on over-prescribing with recommendations and reports following the government’s National Overprescribing Review Report. The campaign looks at solutions of prescribing medication as a last resort rather than the first. It describes social prescribing as one of the key factors in a person’s health and wellbeing. Social prescribing is a non-clinical way of helping people to get more control over their health. Social prescribing link workers take referrals from local agencies and help individuals connect with a range of activities typically provided by voluntary or community organisations, including things like the arts, cricket, swimming, gardening, cookery and learning projects.
This campaign has six calls to action:
- Improving medical and healthcare training. Social prescribing and a psychosocial approach to treatment needs to be embedded throughout the curriculum
- Addressing financial incentives within the NHS. Financial incentives in the system should centre around community health. For those patients already on a cocktail of pills, medication reviews and appropriate deprescribing need to be emphasised
- Increasing the number of social prescribing link workers. Primary Care
- Networks need to employ more link workers to enable access to social prescribing for everyone who could benefit
- Increasing support for the voluntary sector. Government departments need to fund and support voluntary initiatives that encourage healthy communities
- Empowering individuals and communities. Informing individuals about social prescribing and collaborating with volunteers involved in social prescription and local health creation and showcasing benefits
- Further systematic research. Mobilising the research community to develop a fully-fledged programme review into topics including the therapeutic efficacy of social prescribing
Having benefited and used an art class to not only get me off the medication, but to give me my life back and allow me to thrive with my health conditions, I am only too happy to help and back this campaign.
There are some practical tips for professionals to extend appointment times for medication reviews, stating they should be at least 30 minutes long. Whilst there are several thousand clinical pharmacists who have been asked to focus on medication reviews, there are still some 8000 GP practices that have some way to go to achieve at least one clinical pharmacist. Ideally, there should be six or seven per primary care network (PCN). Whilst this seems encouraging it is still some way to start addressing the issues and really looking at the patient’s medication, why it was prescribed and if this really is the best way to treat the patient.
Anyone can of course ask for their medications to be reviewed, but another issue that might need addressing is the electronic summary care record (SCR). Doctors can see and write in this record, but the community pharmacist can only read it. It is not always stated what medications have been prescribed for what condition. If we are employing community pharmacists for medication reviews we must allow them the access and information to provide a comprehensive and trustworthy review.
The use of social prescribing link workers is a much more personalised way of dealing with a patient holistically. The link workers look at the practicalities of the patients’ lives, rather than just their conditions. They have the time to listen, respond, signpost and action any issues that might not be medical. My concern with link workers is the sporadic nature across the country. They are employed by Primary Care Networks (PCN), local authorities and through contracts via NHS trusts. This lends itself to a postcode lottery where some areas get the gold standard and others are left struggling to bumble along. I would like to see a standard of practice across all employed agencies to offer equal services to all.
I had some reservations about link workers in the beginning, but they have proved their worth especially throughout covid and lockdown where they kept people connected and checked on the most vulnerable, to remind them they were not alone.
Whilst I’m realistic that not everybody will benefit from social prescribing, the side-effects of an art class, football group, knitting, or singing (for example) are negligible to the side-effects of overprescribing of medications. With creativity offering cradle to the grave projects, with no religious, cultural, sexual or prejudices of any kind it is easy to see why it can (and should) be used so widely to assist in improving the strain on the NHS.
About the Author
Debs Teale is an advocate of creativity in health following her own remarkable journey. She advocates creativity as an additional service to improve wellbeing and offering hope and aspiration. She has a passion to promote everyone having a voice and a choice in their own care, something she felt lacked in her own journey. Debs believes everyone has something to bring to the table, even if it is just themselves. She is a Trustee at the National Centre for Creative Health as well as a member of the Social Prescribing Network and Social Prescribing Academy. Debs is part of the our Spokesperson Network Programme.
A version of this article was first published by the College of Medicine and Integrated Health.