Can’t afford the opera? Your GP will prescribe a visit.
Matt Hancock took time out on Wednesday to announce a new National Academy. It turns out that this has nothing to do with conventional academia. “Social prescribing” is having the NHS pay for our leisure pursuits – as if it did not cost us enough already. Our Health Secretary was “setting out his ambition for every patient in the country to have access to social prescribing schemes on the NHS as readily as they do medical care.
Social prescribing involves helping patients to improve their health, wellbeing and social welfare by connecting them to community services. This can include activities such as art and singing classes.”
Social prescribing, in a small way, has been around since the 1990s. More than 100 schemes exist in the UK, 25% or so in London. The General practice forward view (2016) proposed that the NHS appointed a national champion for social prescribing and said (p.28): “we will also work with CCGs to ensure they institute plans to address patient flows in their area using tried and tested ideas such as access hubs, social prescribing and evidence based minor ailment schemes.”
The Kings Fund is more sceptical: “robust and systematic evidence on the effectiveness of social prescribing is very limited. Many studies are small scale, do not have a control group, focus on progress rather than outcomes, or relate to individual interventions rather than the social prescribing model. Much of the evidence available is qualitative, and relies on self-reported outcomes. Researchers have also highlighted the challenges of measuring the outcomes of complex interventions, or making meaningful comparisons between very different schemes.” The claimed a 38% (in some areas) reduction in the use of hospital A&E units for example, which makes one wonder why those people were attending A&E in the first place if all they wanted was a little socialising.
There has been no serious quantification of the costs versus the benefits, something one might have expected a cash-strapped NHS to undertake before rolling a National Academy out across the country. Nor has there been any comparative study of which types of social prescribing are most effective for which conditions. There is just a generic claim that social prescribing is good for patients. Guinness is probably better. How much faith would one put in a GP who said “medicine would help your condition but I have no idea which one”?
The announcement of the National Academy had no evidence to support it, and no expected financial benefits. “The indepedent [sic] academy will receive £5 million of government funding”, presumably per annum, but that ignores the boosting of social prescribing from 60% to 100% of the NHS. Inter alia, “The National Academy for Social Prescribing will work to increase awareness of the benefits of social prescribing by building and promoting the evidence base.” How one-sided is that?
If the objective of the new academy was to reduce the costs of the NHS, and/or increase the benefits at the same cost, we should take it seriously. But it is not. The objective is solely “to help more people benefit from arts, sport and leisure activities across the country.” Matt Hancock is jumping on a fashionable bandwagon with no evidential support and throwing away taxpayer money in the process.