An editorial I contributed to as co-author has now been published in the Journal of the Royal Society of Medicine (open access pdf link). The editorial explores how we can and need to progress in establishing social prescribing as nationally accepted and used approaches to improve health, care and wellbeing. We touch on the ongoing discussions on the evidence gap and questions facing social prescribing.
This leaves us in a position where we, as a healthcare community, are delivering a set of interventions that may be delivering no benefit and may be causing harm because of side effects or the opportunity cost entailed in diverting finite healthcare resources to potentially low value interventions. As an international healthcare community we must actively establish the evidence base around social prescriptions to understand what role they can play.
We make the case for a formulary in social prescribing underpinned by evidence but there is also a need to agree on what we mean by evidence and methodology.
Given the ability to rapidly modify social prescriptions, alternative methods of evidence generation like pragmatic control trials, which measure effectiveness as opposed to explanatory trials which measure efficacy,[13] and implementation frameworks, which aim to identify methods that can promote the implementation of research findings into practice,[14] may be more practical means of generating the evidence base around social prescriptions.
There's huge potential for social prescribing to impact health and care provision with potential to deliver higher value healthcare through improving well-being, prevention and self-care. As explained in the editorial the multiple stakeholders within a complex health and care system from patients, to clinicians to policy makers also benefit.
But, formulary's have limitiations...
risk that formularies could over-medicalise interventions that are aimed at addressing social factors and there is also a risk that standardization could prevent people benefiting from local innovative initiatives that are not included in formularies
If implemented appropriately the promise of a formulary is to create harmonised social prescriptions on a national level enabling localisation through engagement with clinicians, local government, voluntary and community, patients and the public.
Formulary's are vehicles for transparency of evidence, efficacy, choice and safety giving confidence in the use of social prescriptions bringing them to parity with medication led interventions. Read the entire editoral through the Journal of the Royal Society of Medicine or open access pdf.
Sincere thanks to co-authors Anant Jani, Erica Pitini, Sven Jungmann, Giovanna Adamo and Jon Conibear.
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