Briefing: Could social prescribing boost health?

Submissions to a Holyrood inquiry looking at whether GPs should prescribe activity reveal a wide range of views

Tuesday 10th September 2019

Going for a walk with friends, taking up sport, cooking a meal and spending time pottering in the garden have long been popular pastimes for many.

Now there is growing interest in the idea that GPs and other frontline healthcare workers should be prescribing such activities to their patients.

Holyrood’s Health & Sport Committee is carrying out an inquiry looking at how this kind of ‘social prescribing’ – usually with the help of a ‘link worker’ who can help identify the best programmes for patients – could help prevent illness, obesity and poor health in Scotland.

A series of written responses submitted to MSPs have outlined the wide range of views on the issue.

Examples of the success of existing social prescribing programmes are given by Glasgow Life – which include an exercise referral scheme, ‘vitality’ classes for people living with medical conditions and health walks.

It says: “They are well-attended and we know that when people do take the first step to attend they are likely to stay.

“The challenge is around getting certain groups of people to take the first step.”

Yoga for Healthy Lower Backs, a national social enterprise, gives the example of a social prescribing scheme in Cornwall that it is involved with. Patients are referred by a GP or link worker and contribute £100 to the course costs.

There was a 78% attendance rate and 71% of people reported an improvement in coping with pain, with one attendee saying: “Helped majorly. Off all medications for pain and de-stressed.”

Professor Richard Davison, of the University of the West of Scotland and a board member of the Observatory for Sport in Scotland, suggests that GP surgeries could even be “embedded into sport centres” to provide exercise opportunities and show “the direct links between health and increased activity”.

“’Exercise is medicine’ and this needs to be reinforced,” his submission says.

However when it comes to what type of activities should be prescribed, the British Dietetic Association says it should not just be restricted to physical activity and support, but also “include a wider position on health and well-being, including diet and nutrition”.

Cultural organisations also argue they have a role to play, with the Scottish Library and Information Council pointing out services offered by public libraries have changed over the years.

“One area in which strong focus has been placed has been the support which public libraries play in combatting social isolation, supporting mental health and well-being and supporting individuals with their health literacy needs which supports self-management of long-term conditions,” it says.

Museum Galleries Scotland also urges the inquiry to consider the important contribution which “cultural heritage and the work of Scotland’s museums sector could make to social prescribing as a practice.”

However others have highlighted issues which can impact on the success of social prescribing initiatives, with Highland Green Health Partnership pointing out there an be difficulties in travelling to leisure facilities in rural areas.

Stigma is also a problem in small communities, it says, adding: “People do not want to be labelled when being referred to activities.

“It is harder to remain anonymous in rural communities.”

The Scottish Council for Voluntary Organisations  raises concerns the trend towards social prescribing in the health service has not considered the increased demand on services which it will generate.

The submission states: “Most of the attention has been spent on considering how the burdens which are placed on health services can be eased.

“In other words, social prescribing could be viewed as an attempt to shift a burden from the NHS towards the voluntary sector.

“If resource is not provided to cope with the extra demand on voluntary services, then the problem is not solved.”           

Barnardo’s Scotland warns young people can still struggle financially even if they are given subsidised gym passes, for example, due to costs such as travel and clothing meaning “these activities remain inaccessible for some young people.”

Dr Katie Walter, a GP in Inverness, also argues there needs to be wider efforts to improve the environment in which we live to increase opportunities for walking and cycling.

In a submission she says: “I cannot recommend someone to cycle if the streets or roads near them are not safe for that.

“There is a key issue around social inequalities here.”