UK: Social prescribing on the NHS (and possible implications for ME/CFS services)

I think social prescribing involves things like prescribing swimming lessons, exercise classes, gym attendance and classes, learning how to meditate and/or mindfulness, dancing classes, and referring people to rambling groups, working on allotments or community gardening. I don't know whether the actual activities live up to the hype.
 
If you can actually get an allotment (long waiting lists over most of UK from what I can gather) I'd definitely recommend as being good... Except I haven't been well enough to go to my half plot for over 2 years now (been low ever since PIP assessment and the following upsets and then Tribunal).

OH does it all at present. We mostly grow onions, garlic, shallots and broad beans. Oh, and potatoes. Some flowers too and whichever herbs survive (I think most of them have bit the dust now).

People are mostly friendly there, and from when I did go there to garden I loved watching the crops growing and digging a little (sitting down in a plastic garden chair). It's pretty full on though, and quite a commitment.

A community allotment would probably be more useful for mental health, in that there would be more people around, and maybe some horticultural help and advice available sometimes.
 
I actually think it could be good in theory though how it will work in practice I don't know. Going to a GP and he says nothing wrong with you that wouldn't be fixed by losing some weight and getting some exercise will feel much better if he prescribes a diet group and a fitness class.

It might give people the confidence to go rather than just building up the courage to go to a gym and it gives them permission to spend time (and possibly money) on themselves.
 
I think it could be argued that if funding for community groups hadn’t been squeezed so hard this “medicalised” approach wouldn’t be needed because people would already be getting support without it needing the approval of the NHS.
 
I actually think it could be good in theory though how it will work in practice I don't know. Going to a GP and he says nothing wrong with you that wouldn't be fixed by losing some weight and getting some exercise will feel much better if he prescribes a diet group and a fitness class.

It might give people the confidence to go rather than just building up the courage to go to a gym and it gives them permission to spend time (and possibly money) on themselves.
It's slightly beneficial for healthy people, to a point, and mildly helpful for those with mild health problems. It's otherwise mostly useless.

Building infrastructure for cheap activities, tax credits for things like gym memberships and social clubs and the like are much better ways of achieving the same. It's social spending, just less effective and more wasteful. It's a very patronizing approach that assumes people need to be told what to do, rather than removing the obstacles, usually financial, that make it hard for them to be active. A culture of work obsession is much more to blame than almost any other factor.

Other than that it's mostly busywork, the illusion of doing something for the sake of doing something regardless of whether it is useful, which is the very essence of the BPS model. There are much better ways to promote active behavior, much cheaper and more effective. Ironically enough, this is an actual case of "medicalisation" of normal things, which is the very thing deniers of chronic illness think is happening with people with MUS. But if they had the capacity for self-reflection, they wouldn't be doing the things they are currently doing anyway.
 
Has anyone else received a text from the NHS about social prescribing? It has a link to this video

and asks me if I want “social or community support”.

While I need some support of some kind, as I feel pretty much abandoned by the medical profession, if I had the energy to be social or be part of the community, I would be. There are no other barriers to that and I know of many things happening locally I would jump at, given a functional hour.

There is a phone number. I am almost tempted to ring to see how they deal with me, but don’t want to be labelled as uncooperative with the GP if I say no I can’t do that to all suggestions, so it’s perhaps not good to go there just for devilment.

Might the “link worker“ be a great person who would then talk to my GP and let them know I am needing more specialised attention than a yoga class? It’s a dream...
 
If you can actually get an allotment (long waiting lists over most of UK from what I can gather) I'd definitely recommend as being good... Except I haven't been well enough to go to my half plot for over 2 years now (been low ever since PIP assessment and the following upsets and then Tribunal).

OH does it all at present. We mostly grow onions, garlic, shallots and broad beans. Oh, and potatoes. Some flowers too and whichever herbs survive (I think most of them have bit the dust now).

People are mostly friendly there, and from when I did go there to garden I loved watching the crops growing and digging a little (sitting down in a plastic garden chair). It's pretty full on though, and quite a commitment.

A community allotment would probably be more useful for mental health, in that there would be more people around, and maybe some horticultural help and advice available sometimes.
Definitely. Combat stress organisation have a volunteer horticulturist who runs gardening courses . Very popular and effective.
 
Merged thread

United Kingdom: Social Prescribing - a potential part of ME/CFS services


There is a potentially very serious issue about the likely direction of travel for ME Service - its likely reliance on UK initiative, Social Prescribing. It is a threat to NICE NG206.

I just Googled 'Social Prescribing images' and was really concerned at what I found. It's shocking in relation to ME/CFS services for patient care. It effectively ignores the NICE approach.


Social Prescribing
‘Putting people at the centre of health care’



the-social-prescribing-network-300x261.png


Home of the Social Prescribing Network


What is social prescribing?
Social prescribing is a means of enabling professionals (often healthcare practitioners) to refer their people to ‘link workers’ or ‘social prescribers’ who are specially trained to support people in identifying and designing their own personalised solutions to help with social, emotional or practical needs to improve their health and wellbeing. This often utilises voluntary, community, faith and social enterprise services such as choirs, gardening clubs, exercises classes, art groups and many more.'


Screen Shot 2021-11-09 at 22.09.07.jpg
The picture was from one of the King's Fund https://www.kingsfund.org.uk/publications/social-prescribingnominated providers website. I did not draw it! Here: https://collegeofmedicine.org.uk/social-prescribing/

The Academy rep GP did this video on it a while ago. https://www.kingsfund.org.uk/audio-video/helen-stokes-lampard-social-prescribing (Dr Helen Stokes-Lampard, Chair of the Royal College of General Practitioners, discusses how the use of social prescribing supports general practice to deliver high quality, holistic care.

This presentation was recorded at our conference, Social prescribing: from rhetoric to reality, on 18 May 2017.)
She co signed the awful letter effectively rejecting NICE in BMJ as well.

Our Local Clinic Executive have a lead who has already in 2019 suggested our ME Proposed service incorporates this initiative (with MUS, FND and IAPT).....
 
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I am conflicted about this. When I first became housebound I took it very hard and felt useless, lonely and despairing. The OT referred me to a local initiative for the disabled where they took me in a taxi to a centre where I did silk painting.

It changed my life. As someone who had never been well enough to have a job I was able to look at my artwork and see that it was as good as anyone else's when I had become certain that I was intrinsically a failure. And I made a friend who became like a sister to me. She had cerebral palsy but was able to drive so could visit me.

When my children were young I could have done with a volunteer who would visit me or even better, I knew of some children who were taken to school by volunteers because their mothers had recognised diseases.

If we can steer it away from exercise programs there may be some benefits for people with ME.
 
There is a potentially very serious issue about the likely direction of travel for ME Service - its likely reliance on UK initiative, Social Prescribing. It is a threat to NICE NG206.

I just Googled 'Social Prescribing images' and was really concerned at what I found. It's shocking in relation to ME/CFS services for patient care. It effectively ignores the NICE approach.


Social Prescribing
‘Putting people at the centre of health care’



the-social-prescribing-network-300x261.png


Home of the Social Prescribing Network


What is social prescribing?
Social prescribing is a means of enabling professionals (often healthcare practitioners) to refer their people to ‘link workers’ or ‘social prescribers’ who are specially trained to support people in identifying and designing their own personalised solutions to help with social, emotional or practical needs to improve their health and wellbeing. This often utilises voluntary, community, faith and social enterprise services such as choirs, gardening clubs, exercises classes, art groups and many more.'


View attachment 15727
The picture was from one of the King's Fund https://www.kingsfund.org.uk/publications/social-prescribingnominated providers website. I did not draw it! Here: https://collegeofmedicine.org.uk/social-prescribing/

The Academy rep GP did this video on it a while ago. https://www.kingsfund.org.uk/audio-video/helen-stokes-lampard-social-prescribing (Dr Helen Stokes-Lampard, Chair of the Royal College of General Practitioners, discusses how the use of social prescribing supports general practice to deliver high quality, holistic care.

This presentation was recorded at our conference, Social prescribing: from rhetoric to reality, on 18 May 2017.)
She co signed the awful letter effectively rejecting NICE in BMJ as well.

Our Local Clinic Executive have a lead who has already in 2019 suggested our ME Proposed service incorporates this initiative (with MUS, FND and IAPT).....



I see your concern. That the things those who have ME generally all need is medical checks and functional support - ie the last thing they are is thick and needing the concept of 'pacing' described in detail, they do however often live in a world that actively makes that impossible unless someone is going to help with adjustments, ensuring those around said person behave and don't do things that are detrimental (ie suck up the BPS stuff wholesale and start making them run round - yes many do that) benefits, support, care.

Suggesting this as an 'instead', when it could have 'any of the above' e.g. might only offer painting somewhere isn't making sure that PwME receive ANY of the required aspects of the guidelines, because the place they are dumped can't offer them. Instead offering something that requires exertion to many who don't have that spare as a fundamental symptom of their condition shows utter misunderstanding and disregard. There are no guarantees said people are even going to know a thing about ME to ensure activities are indeed accommodating them.

I hate how so many people get away thanks to bystanders all doing it with saying 'I don't want to know' or 'I already know' and assuming ME is like any other condition where offering a bit of 'nice chat' or 'destress' is a good thing. It would take them a tenth of that time spent harming someone to read the doc they've been asked to and find out about exertion and hypersensitivity. But prefer to hold onto their ignorance - I suspect specifically due to the BPS spreading all their tosh around for so long making it a 'dirty subject'. How is that allowed and not seen as deliberately inducing heavy discrimination in all areas against a group of people?
 
RE Social P above.... see slides recently discovered....... re Long Covid.



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'Robert Saunders (aka McMullen)
@RobertHMcMullen

I was invited to join this meeting to ask a question about #MECFS and #LongCovid. Because I have severe ME, I asked for a specific time so I could rest beforehand. Very disappointed that I was not invited to speak having made such an effort to attend......'
'Barbieloo@BarbR666

SAGE needs to agenda this. L Covid service provision scrutiny shows has been subsumed within existing ME special secondary clinics overwhelming them & rebounding as Rehabilitation-failing NICE competency & compliance.
Replying to
@BarbR666

@Daltmann10
and 6 others
Expanded clinics have recruited HCPs blissfully unaware & untrained in ME & PEM NICE CG205. It's clinical negligence endorsed & funded under NHS England NHS "Improvment" watch. It has to stop.
Replying to
@BarbR666

@Daltmann10
and 6 others
Gillian Leng needs to speak out & flag this. CG205 was reviewed and published under her NICE watch & tenure.'
 

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Not sure if this systematic review wants a new thread?

I've not read up on the details but saw it getting some attention:

https://bmjopen.bmj.com/content/12/10/e062951




Effect of social prescribing link workers on health outcomes and costs for adults in primary care and community settings: a systematic review






Bridget Kiely1, Aisling Croke1, Muireann O'Shea1, Fiona Boland2, Eamon O'Shea3, Deirdre Connolly4, Susan M Smith1,5
Correspondence to Dr Bridget Kiely; bridgetkiely@rcsi.com


Abstract

Objectives To establish the evidence base for the effects on health outcomes and costs of social prescribing link workers (non-health or social care professionals who connect people to community resources) for people in community settings focusing on people experiencing multimorbidity and social deprivation.

Design Systematic review and narrative synthesis using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach.

Data sources Cochrane Database, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, EU Clinical Trials Register, CINAHL, Embase, Global Health, PubMed/MEDLINE, PsycInfo, LILACS, Web of Science and grey literature were searched up to 31 July 2021. A forward citation search was completed on 9 June 2022.

Eligibility criteria Controlled trials meeting the Cochrane Effectiveness of Practice and Organisation of Care (EPOC) guidance on eligible study designs assessing the effect of social prescribing link workers for adults in community settings on any outcomes. No language restrictions were applied.

Data extraction and synthesis Two independent reviewers extracted data, evaluated study quality using the Cochrane EPOC risk of bias tool and judged certainty of the evidence. Results were synthesised narratively.

Results
Eight studies (n=6500 participants), with five randomised controlled trials at low risk of bias and three controlled before–after studies at high risk of bias, were included. Four included participants experiencing multimorbidity and social deprivation. Four (n=2186) reported no impact on health-related quality of life (HRQoL). Four (n=1924) reported mental health outcomes with three reporting no impact. Two US studies found improved ratings of high-quality care and reduced hospitalisations for people with multimorbidity experiencing deprivation. No cost-effectiveness analyses were identified. The certainty of the evidence was low or very low.

Conclusions There is an absence of evidence for social prescribing link workers. Policymakers should note this and support evaluation of current programmes before mainstreaming.

Press release:

https://www.eurekalert.org/news-releases/967865

SMC: https://www.sciencemediacentre.org/...comes-in-primary-care-and-community-settings/
 
Just anecdotal - I have a "social prescriber" that my GP sorted out for me.. In theory they were going to help me through the process of dealing with the DWP (applying for PIP & UC LCW), in reality I just got on with doing those things. The social prescriber was calling me every 2-3 weeks to check progress, but as I never had any updates due to DWP being so slow at the moment, they recently said I should email them when I got the decisions to let them know, and if I needed help/support with the applications at that point.
So my general impression so far has been harmless, but not useful, just a big 0 at this point.
If my DWP decisions come back negative, it will be interesting to see what kind of help and/or support the social prescriber can provide.
 
Just anecdotal - I have a "social prescriber" that my GP sorted out for me.. In theory they were going to help me through the process of dealing with the DWP (applying for PIP & UC LCW), in reality I just got on with doing those things. The social prescriber was calling me every 2-3 weeks to check progress, but as I never had any updates due to DWP being so slow at the moment, they recently said I should email them when I got the decisions to let them know, and if I needed help/support with the applications at that point.
So my general impression so far has been harmless, but not useful, just a big 0 at this point.
If my DWP decisions come back negative, it will be interesting to see what kind of help and/or support the social prescriber can provide.

There seems to be an issue here (and I also imagine there are other services where there are similar parallels) in that SOcial Prescribers can only signpost. In an area where e.g. there seem to be lots of services, but actually for e.g. ME all those services don't meet the needs of those with ME

Plus underneath all those apparent services, all but one point back to/only signpost to one service - that has 2/3 volunteers trying to service a county or city - you have this situation where the number of signposters:services is ridiculous. None of the signposters can even report there are actually no services. Even if their research finds this is the case.

Are these signposters being funded instead of services (even if they'd be happy to offer said services)? If so it's just a big old hollow thing with nothing underneath.

EDIT*: I've just realised of course that this is the classic definition/example of the term failure-demand. e.g. where you end up with snowballing emails caused by not having enough resource to do the job so spend more and more time replying to 'where's my x' and complaints (which take time away from doing the job itself).
 
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There seems to be an issue here (and I also imagine there are other services where there are similar parallels) in that SOcial Prescribers can only signpost. In an area where e.g. there seem to be lots of services, but actually for e.g. ME all those services don't meet the needs of those with ME

Plus underneath all those apparent services, all but one point back to/only signpost to one service - that has 2/3 volunteers trying to service a county or city - you have this situation where the number of signposters:services is ridiculous. None of the signposters can even report there are actually no services. Even if their research finds this is the case.

Are these signposters being funded instead of services (even if they'd be happy to offer said services)? If so it's just a big old hollow thing with nothing underneath.
Yes now that you say that the SP has definitely said a few times that their role is "just to signpost"... I didn't really think much about what that meant when they said it.
 
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