Social prescribing should be ‘first line of defence’

Monday 5th August 2019

Social prescribing of physical activity should not be seen as a ‘quirky’ new project but the ‘first line of defence against health problems’, according to a physiotherapist.

Derek Laidler, professional lead physiotherapist at Argyll & Bute Health and Social Care Partnership, says the ultimate aim should be to have it placed at the centre of health and social care services.

He argues there should be an acknowledgment that exercise can be a ‘preventative vaccination programme’ against ill-health, rather than ‘just another medicine to help when ill-health has already set in.’

His call has been made in a submission to Holyrood’s Health & Sport Committee, which is carrying out an inquiry to consider how social prescribing can tackle poor physical and mental health in Scotland.

Social prescribing, which has been used since the 1990s, enables GPs and other health staff to refer patients to a link worker, who can help them find activities to improve their health and wellbeing – that can include exercise and sport or other types of recreational activities.

Mr Laidler says one difficulty is that society is conditioned to think medicine is the only answer to health problems and the ‘NHS as the gatekeepers to this model hold the responsibility for people’s health or ill-health’.

His response said: “As a result we need to change the message from ‘exercise is the remedy’ to ‘inactivity is the problem’, a subtle but important change in our message.”

He raises concerns over the acceptance of poor health and function as ‘a natural part of ageing’, particularly as ‘we live in an era where it has never been easier to do nothing’.

He said: “Sarcopenia, the age-related loss of muscle bulk which leads to reduced mobility and falls starts at the age of 30.

“It is inactivity in the elderly that allows sarcopenia to start impacting on mobility and safety rather than age itself, yet most people will consider buying Granny a riser recliner chair rather than a gym membership when she starts to struggle.

“Until we articulate the greater importance of activity and exercise for our older population, we will struggle to convince many people of the value of exercise by social prescription.”

A submission from John Brennan, senior health promotion specialist in physical activity at NHS Lothian department of public health and health policy, raises concerns about the perceptions of social prescribing by both professionals and the public

He said: “The variation in models may seem that some medical professionals may feel that social prescribing is woolly, unfamiliar and clinically unproven.

“Patients may be unwilling to accept that a referral to a walking group for their hypertension or being referred to a gardening group for mild anxiety, as part of their treatment, is too novel or may perceive the intervention as a cheap alternative to being prescribed something pharmaceutical.”

He suggested initiatives, such as the training of health staff in social marketing campaigns, could help to increasing awareness and understanding of the benefits of social prescribing.

A submission from Scottish Disability Sport raises concerns about the significant barriers which disabled people face in participating in physical activities.

It cites statistics which show only 20% of people with disabilities take the recommended level of physical activity, compared with 52% of non-disabled people.

The submission said: “If the barriers that significantly impact on disabled people’s ability to engage in physical activity and sport are to be addressed, a joined up and innovative approach has to be taken to change the current culture of inactivity.

“Social prescribing can only be successful if there is a Scotland-wide approach with high level commitment and significant resource from government, the health sector and the wide variety of partners from the public and third sector.”