There is an awful lot going on with what is broadly known as ‘social prescribing’. The term ‘social prescribing’ covers a range of complimentary community led initiatives that seek to bolster health (and the health service) by reconnecting the individual to the community. This simple tactic leverages the power of community and connection to combat isolation and re-empower the individual to take control of their life (and health). There’s a lot of theory sitting behind this (from sociology, psychology, neurology etc) but most people instinctively ‘get’ that a patient who feels empowered to make health decisions, feels connected to their community and not isolated or alone is someone in a much better place – mentally and physically. In other words, healthier. You can look on the King’s Fund website to see acres of research and theory but for now let’s assume this is a good thing.
And not just a good thing for individuals and society – but a good thing for public sector finances – as a healthier populace is a cheaper populace! This is another one of those public policies that is trying to be win-win all round: saving money, improving health and strengthening communities. All the players have their preferred angle but the same end goals. And though there are many different ways of doing this there is a fairly firm divide between those taking a tech led approach and those taking a human led approach. Essentially the question is, is it best to have a tidy transactional pathways – a database of community activities accessible at the touch of a button to the GP? Or messy, relational, connections – a volunteer who chats to patients and connects them into the local community?
“A further variable is the extent to which the scheme is transactional or relational, offering GPs a pathway beyond general practice or creating a more fluid interface between general practice, community organisations and communities themselves.”
From the Kings Fund report “Volunteering in general practice; opportunities and insights”
There is a perception on the ground that a disproportionate amount of effort (and resources) are going into attempts to create tech led ‘solutions’. Volunteering, talking to people ‘in real time’ is seen as somehow old fashioned. The tech vision is beguiling – a database of local activities that the GP can signpost the patient to – job done! If only it was so simple. The barriers to this model of working are myriad: How do all the local opportunities get listed (don’t say distribute an API! it’s not going to happen! Ask those who have tried.) Will the GPs really go through the database and make recommendations or referrals (doubtful). Self referral – do the target demographic browse databases of local opportunities which they then select, book or turn up to? No!
Our experience is that tech can help in many ways but the core principle of a model that works has to establishing trusted relationships. That means a cadre of regular volunteers, sitting in GP waiting rooms, striking up conversations. It’s all very much IRL (in real life), but that doesn’t mean that there isn’t a role for tech. We’ve merely found that ‘live ware’ is the primary technology involved and ‘software and hardware’ are very much in a supporting role. Yet frustratingly the lure of the tech ‘solution’ means that the money is generally being scooped up by wizzy tech startups and the people led initiatives struggle to attract the small sums of money that are needed to make these schemes work. In our borough alone there are multiple, competing tech startups enjoying public sector support, but delivering a questionable amount of ROI (return on investment).
However, there is plenty of tech that we do find useful:
- Smartphones and tablets
- Survey monkey (for evaluation and needs analysis)
- Emails and Texts for contacts. Social Media.
- CRMs (Contact Relationship Management software)
- Websites for disseminating information, hosting databases and directories, sharing resources
- Eventbrite for organising and booking events. etc
But an all singing, all dancing social prescribing referrals system is not something that there is any evidence is needed or will work. Granted, when the current generation of millennials start ageing in 30 or 40 years time they will find tech solutions come naturally to them. No doubt they will combat loneliness with an app (Lonlyr?) and continue to use their social networking (facebook, instagram etc) to keep social contacts alive. But I suspect they will still want to talk to someone IRL, at least occasionally.
