Campaign for social prescribing (CASP)
By John Kapp, [email protected], 01273 417997. 5.12.18
1.Summary. The budgeted £2
Social prescribing has a big and growing evidence base as a cost-effective way of improving health and wellbeing of patients in their local community. It has been pioneered for decades by enlightened GPs in a few surgeries in England, such as Bromley by Bow in London,
The problem, which this paper addresses, is that these social ‘prescriptions’ are not officially part of the prescribing system, and are not written on a prescription form, as for drugs. Nor are they paid for out of the NHS prescribing budget, and are not usually free at the point of use for patients, the poorest and neediest of whom may be excluded by
Brighton and Hove
As with drug prescriptions, the GP would write the patients’ name on the prescription form for the appropriate social intervention of the patient’s choice. The GP would give it to the patient, who would take it to
At present, the only licenced providers are pharmacists, who provide drugs and other health-related products. To implement this new social prescribing scheme, the prescribing system should be expanded to include non-drug interventions. Those interventions chosen for inclusion under the social prescribing scheme would need to be designed and specified, and a system of licencing those qualified to provide them would have to be created and implemented, as this paper outlines.
2 Recommendations to councillors on Health and Wellbeing Boards (HWBs).
The HWB is the committee of the Local Authority Councils who are responsible for about 2/3rds of the NHS budget delegated to the CCGs, currently in 2018/19 about £85
3 Principles of social prescribing.
The social interventions chosen should be those that improve health and
They should be commissioned as NHS interventions, and follow the same principles as other NHS interventions, including being free to the patient at the point of use, so that nobody is excluded by
The licenced provider should be paid for providing the intervention as pharmacists are, at a tariff price based on the going market rate, after submission of the used prescription, monthly in arrears.
The CCGs should design the system with the help of the community and voluntary sector providers.
The CCG should invite providers of interventions to apply to become licenced providers.
To incentivise providers to provide good services, and protect taxpayers interests, payment of providers should be by results, and outcome-based.
Accordingly, before the CCG pays the provider, the patient should be required to sign the used prescription form that the intervention was
4 The interventions that should be included in social prescribing, and expanded with public funding
Singing groups (on the lines of ‘Singing for Pleasure’ and ‘Singing for better health’)
Exercise classes (on the lines of 60+)
Breathe easy groups (on the lines of B&H Breatheasy group)
Bereavement group (on the lines of Cruse)
Befriending groups (on the lines of Neighbourhood Care scheme, Time to talk befriending)
Gardening and allotment groups (on the lines of
Peer support for vulnerable people (on the lines of Groundswell)
Psychoeducation classes (on the lines of Swindon, paper 9.63, www.reginaldkapp.org)
Gym training (
Family Constellation Group Therapy (FCGT) groups (paper 9.124 of www.reginaldkapp.org)
Other groups as submitted to the CCG for inclusion from time to time.
5 How should potential providers be licenced?
Those presently providing these interventions in the private, and Community and Voluntary Sector (CVS) should be invited to join together to create organisations that can provide
If implemented as recommended, the desired outcomes of this campaign will be fulfilled, which are:
To expand the interventions provided by the NHS to include drug-free,
To make primary care sustainable by empowering GPs to prescribe these nondrug interventions as easily as
This will enable them to fulfil their original purpose as teachers (the
This will restore their profession to honourable, ensuring their recruitment and retention in practices, and solve the present crisis in primary care.
Appendix Examples of existing social prescribing schemes.
Bromley by Bow GP surgery in East London have been pioneering social prescribing for the last 30 years, and have been using it to good effect in Tower Hamlets. The following is taken from their website (www.bbbc.co.uk)
‘Bromley by Bow Health consists of over 100 people.
‘SOCIAL PRESCRIBING Get support for issues affecting your health. The social prescribing service gives you time to explore life issues and challenges and puts you in touch with services and activities to support you in your local community. When: By appointment at Bromley by Bow (Health) Centre, St Andrews Health Centre, St Paul’s Way Medical Centre, Stroudley Walk Practice, Merchant Street Practice and XX Place Where: Mile End East and Bromley by Bow
MACMILLAN SOCIAL PRESCRIBING Support for people living with and beyond cancer
The Macmillan Social Prescribing Service will put you in touch with local services and activities to help you get back on track following a cancer diagnosis. When: Various. Please get in touch Where: Tower Hamlets, Newham, Waltham Forest, City and Hackney For: Age 18+ [email protected] ‘
The Service Directory puts you in touch with services and activities to support you in your local community, including the following headings: Fit for life. Become a health champion. Communities driving change. Inclusive sport. Gardening and horticulture. Physical activity classes. Support finding work. Support to find training. Employers looking for staff. English classes. Computer skills. Benefits, housing, debt advice. Specialist advice. Money management. Energy
The Brighton Health and Wellbeing Centre, Western Rd Hove, also offers some of the above socially prescribed services, subsidized by their Robin Hood charity. (see paper: ‘Offer of subsidized MBCT courses’ 9.133 www.reginaldkapp.org)