Most chronic health problems diagnosed and managed in general practice require important lifestyle changes as an essential part of management. Consequently, many things that assist patients to best manage their illnesses lie outside the walls of hospitals and general practice.
Chronic health problems such as obesity, diabetes, vascular disease and musculoskeletal pain have very important “non-medical” aspects to their management. Of course diagnosis, tests, medication and monitoring play a pivotal role in assisting with diabetes – but good nutrition, physical activity and getting into a normal weight range are all things done outside the doctor’s surgery that are also crucial. While a GP educates, advises, motivates and monitors these things, starting and sticking to that advice is difficult.
The benefit of social prescribers centres on their ability to link the patient to what suits them to achieve the outcome needed, starting them on journey and supporting them along the way.
Social prescribers are not health professionals. Rather they are people who GPs can easily connect a patient to and who have a deep knowledge of the local community. They find out from the GP what outcome is needed – be it more physical activity, more social connection or better nutrition and then connect and assist people in pathways to achieve this.
A social prescriber makes the bridge to something that works for that person. They might show a patient the best walking tracks in the area and join a patient for their first few walks, advise how to get affordable access to the swimming pool, shop with them and help them access healthy food, or link them into social activities they enjoy and will participate in such as culturally-suited exercise or art classes. This supported and individualised approach is evidence-based to be much more successful than the previous doctor’s “life script” advising a patient to ‘walk 5ks a day.’
A study by NWMPHN found the biggest single lifestyle issue impacting on the health and wellbeing of their community was loneliness. Loneliness contributes to a myriad of health problems including depression, anxiety, dementia and vascular disease. By connecting people with others and community activities, it’s also something social prescribers can help reduce. NWMPHN is trialing social prescribers at limited practices. Consistent with worldwide evidence that experience is that they are effective and valued by both GPs and patients.
Catherine Cotching is a social prescriber working in this trial. She confirms her role is simply knowing what programs, services and groups are available in the community and how to access them for her clients.
“A GP probably doesn’t have the time to actually know what’s there. They only consult for 15 minutes or 10 minutes and their focus is on the clinical side of things.”
Working in the program has reinforced just how much a person’s ability to be healthy is impacted by their personal and social circumstances.
“Particularly when it comes to financial issues, there’s a direct relationship. If people can’t afford to buy their medications, they can’t afford to buy good food, then obviously their health will deteriorate.”
However, despite strong worldwide evidence that social prescribing works and is cost effective, there is no government funding in Australia. They are also currently out of the scope of the Workforce Incentive Program.
But their role is critical in thinking about how we achieve patient-centred, accessible, effective and sustainable care. We want our patients to make lifestyle changes to address their health challenges. We know what the changes needed are. But we also know they can be very hard for patients to make, particularly our most vulnerable patients.
Social prescribers support GPs’ effectiveness by translating the lifestyle changes that are needed into a language patients can understand beyond the practice. Introducing social prescribers as a core part of the GP team can achieve better health outcomes for our patients and our community.”
A MACH-sponsored Social Isolation and Social Prescribing Conference planned for June 2020 has been postponed until 2021 due to COVID-19. Further details will be provided at a future date.