Onkar Sahota: In health policy, social prescribing can help make many more Londoners truly well

Onkar Sahota: In health policy, social prescribing can help make many more Londoners truly well

Social prescribing, the focus of a new draft vision from the Mayor of London, may sound like another healthcare fad. However, it has the potential to change how we think about looking after people.

A couple of years ago, an in-depth study with a group of East Londoners set out to discover what people thought of as a good life and what health services could learn from that. The answer was simple. Those Londoners told the researchers that they wanted three things: to feel good in themselves; to be connected to others; and to give and get back in equal shares.

Social prescribing is the new mission for the NHS to build this three-legged stool. If it is successful, new ways to recover and stay well will open up for people across the country. But we must be vigilant against the risk of merely tagging social prescribing schemes onto our existing, creaking health system. To really benefit Londoners, the Mayor’s draft vision must ensure this speeds up a deeper change in healthcare.

At its heart, social prescribing follows the simple ethos that there is much more to living well than not being unwell, and says that the NHS should help people do this.

In practical terms, this could mean, for example, that a GP treating a woman suffering from stress discovers that it arises from financial concerns and instead of just prescribing a medicine, could also connect that woman with a debt advice specialist. Or, if a child keeps showing up with bad asthma, then perhaps the answer isn’t to give out more powerful drugs, but to get the borough’s housing department round and fix the damp that’s causing the asthma problem in the first place.

The Marmot Review into health inequalities, published back in 2010, asserts that “taking action to reduce inequalities in health does not require a separate health agenda, but action across the whole of society”. These words are just as relevant today. The NHS should be as determined to reduce inequality as it is to cure specific diseases.

It’s not rocket science that health is shaped by the world around us. As the head of the Royal College of GPs, Professor Helen Stokes-Lampard says: “Social prescribing is not a new idea – good GPs have always done it, it just didn’t have a name”.

We are now starting to see politicians develop the framework to enable GPs to give out social prescriptions, and City Hall is setting out its ambition for all Londoners to have easy access to them.

To realise this, we need to learn from noteworthy case studies in the capital. For example, you can’t talk about social prescribing with mentioning the Bromley-By-Bow Centre, which has turned an old church and a run-down park into a community hub running everything from employment advice to gardening clubs alongside GP appointments. There is also the Lambeth GP co-op, where patients grow food on NHS land, and the Guys and St Thomas’ charity, which has pioneered healthy high streets in Walworth.

Three things unite these pathfinders. Firstly, they ask what each individual they see needs from them in order to be truly well – not just how to fix what’s immediately in front of them. Secondly, the make the buildings themselves part of the project. Finally, each runs schemes that help their patients but also help develop the area where those people live, improving the wider determinants of health.

The Mayor and NHS bosses need to capture this radical and innovative spirit. Social prescribing is too big an opportunity to patch on as an addendum to a health service focused on hospital procedures, crucial as those are. This is a promising new path for our fractured welfare state. Let’s not miss it.

Onkar Sahota is the London Assembly Member for Ealing & Hillingdon and has been a family doctor in West London since 1989. 

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