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04 • Practice


PRESCRIBING HAPPINESS


From bingo to Bollywood and bird watching, GPs are being encouraged to prescribe social activities to fight loneliness… But does it work?


I


T HAS been described as one of the greatest public health challenges of our time and is linked to a range of damaging conditions such as Alzheimer’s disease, heart attacks and strokes. Loneliness is said to be as harmful to health as smoking 15 cigarettes a day, but opinions are divided as to how best to tackle it. The UK government unveiled its proposals to address the issue in


October with the launch of its “loneliness strategy” for England and Wales. The plan gives GPs a central role, specifically in the practice known as “social prescribing”, which allows clinicians to direct patients to a variety of arts and cultural activities such as cookery classes, walking clubs and more.


Health and social care secretary Matt Hancock describes social


prescribing as an “indispensable tool” to tackle “ageing, loneliness, mental health and other long-term conditions.” It is hoped offering non-clinical solutions could reduce demand on the NHS and improve patients’ quality of life. Similar strategies launched by the Scottish and Welsh governments also seek to expand social prescribing.


Positive effects While some doctors may be sceptical as to the effectiveness of such schemes, social prescribing has been backed by NHS England as one of its 10 high-impact actions aimed at freeing up GP time. Analysis by the RCGP also found it was one of the most effective of those 10 high- impact actions at reducing GP workload and called for dedicated social prescribing to be integrated into practices. The King’s Fund has published a range of information on the topic.


It states: “There is emerging evidence that social prescribing can lead to a range of positive health and wellbeing outcomes. Studies have pointed to improvements in areas such as quality of life and emotional wellbeing, mental and general wellbeing, and levels of depression and anxiety.” The Fund highlights a study into a social prescribing project in Bristol


which found improvements in anxiety levels and in feelings about general health and quality of life. It adds: “In general, social prescribing schemes appear to result in high levels of satisfaction from participants, primary care professionals and commissioners.” But it also accepts that robust and systematic evidence on the effectiveness of the practice is “very limited”. Practices who do adopt social prescribing have a wide range of activities to choose from.


Parkrun Parkrun has grown massively since its launch 15 years ago. It organises free, weekly, 5km timed runs at more than 600 locations around the UK and abroad, attracting more than 140,000 runners each week. In 2018 the Royal College of GPs joined forces with Parkrun UK to


“promote the health and wellbeing of staff and patients.” Under the initiative, the College is encouraging practices to become official “Parkrun practices” and so far 700 across the UK have signed up. Southport GP and Parkrun ambassador for health and wellbeing


Dr Simon Tobin spoke at the 2018 RCGP Conference of his practice’s success in encouraging patients (and staff) to take part. Parkrun, he says, gives people “a purpose and a community”. He told the stories of several patients (with their consent) who had


benefited. He described how type 2 diabetic Gary had been considering joining a local Parkrun event but was reluctant because “I’m not a runner.” Spurred on by Dr Tobin’s reassurance that 25 per cent of Parkrun participants walk the route, Gary has since lost 13kg and has been able to come off his medication. Another patient, Eileen, had struggled with her weight and alcohol


intake in addition to depression and anxiety. On Dr Tobin’s suggestion, she tried Parkrun and has since completed a half marathon. The GP adds: “It gave her a real self-esteem boost and her health is very much improved.”


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