There’s something about social prescribing

Abstract

What do we do when our faith in medical cures begins to wane? What do we do when we worry about overtreatment and overdiagnosis? What do we do when the medical-industrial complex, as first described by the Ehrenreichs in 1969, is omnipotent? What do we do when hospital wards are full of patients awaiting social care, general practices are crammed with people whose wellbeing depends on solutions other than pills and surgery, and an ageing population seeks answers to loneliness and isolation? There is no panacea. There never was. But social prescribing offers something to hang on to.

What that something is, isn’t yet entirely clear. The evidence base on social prescribing is described as ‘emerging’ at best. Social prescribing may be another false hope, the latest fad in an age of running after fads. We may look back in future and shake our heads at our overenthusiasm for something that seemed too good to be true.

But, hang on. There is something in social prescribing, isn’t there? The best route to population health is to address the social determinants of health, said Geoffrey Rose twenty years ago. Hobson described the importance of social well-being in 1949 as, ‘A happy family circle, a full and adjusted community life at work and at play.’ More recently, the work of Michael Marmot has firmed up arguments about the centrality of social determinants to health and wellbeing. And yet, social prescribing is an idea whose time has only just arrived.

Anant Jani and Muir Gray launch a new series this month that will dissect social prescribing and, since they are advocates, explain how to make it mainstream.¹ What is the current state of the evidence base? What is the role of technology? How can social prescribing work alongside precision medicine? What resources are required to make social prescribing effective? How does social prescribing support active ageing? These and other questions will be answered in the coming months. These issues are worthy of debate, say Jani and Gray, because the direction of social prescribing is not inevitable or deterministic.

Equally, you may wish to debate what lies beyond whistleblowing,² the role of public and patient involvement in research in low- and middle-income countries,³ evidence on the safety of locum doctors⁴ a first-hand account of an early dispute over access to trial data,⁵ or the ‘gaping hole’ in the application process for higher and specialist training.⁶ For those of a certain disposition, and I count JRSM readers among them, there is something in debate as a social prescription.

References

Jani A and Gray M. Making social prescriptions mainstream. J R Soc Med 2019; 112: 459–461.

Higgins J and Reitz M. If whistleblowing is the answer, ask a better question. J R Soc Med 2019; 112: 453–455.

Essex R, Ocloo J and Rao M. The need to establish sustainable public and patient involvement in research in low and middle income countries. J R Soc Med 2019; 112: 456–458.

Ferguson J and Walshe K. The quality and safety of locum doctors: a narrative review. J R Soc Med 2019; 112: 462–471.

Meinert C. The trials and tribulations of the University Group Diabetes Program 1: the trial and the controversies. J R Soc Med 2019; 112: 476–482.

Shawe-Taylor M, Grant M, Chaudhry Z and Harper A. Medical job progression:the missing link. J R Soc Med 2019; 112: 483–484.