Social prescribing is where patients are directed towards non-medical activities as a potential route for supporting patients off dependence on prescription medication.
Social prescribing has been around since at least the 1970s. It became front page news earlier this month in the build up to the Spring Budget on 15th March, as a way of saving the NHS millions of pounds.
Tackling Dependence
New guidance from NHS England identified ways to care for patients who need support to move on from pain relief medication or anti-depressants. There is recognition that for some, these medications can create a dependency which may extend beyond the point where the medication is useful or necessary.
Tackling dependence on prescription medicine requires a “person-centred approach” and the guidance makes clear that: “Prescribers should ensure that patients have the capacity to enter into the shared decision-making process”.
Adult Learning Activities
Social prescribing emerges as one of the first-choice options. Such activities include arts and crafts, cookery, nature walks and music.
All of these activities give the participant a level of confidence, control and focus beyond their pain or dependency.
The activities need to be part of a wider care package. They are not a cure in themselves, but their effect is significant and social prescribing could be expanded into other settings.
In a case study published in the new NHS guidance, 83% of participants in an art session showed a statistically significant improvement in their well-being. The sessions were delivered by artist facilitators with lived experience of persistent pain, reinforcing the bond between facilitators and participants.
WEA Research
At the WEA, we see from our own impact research that 84% of learners report better well-being – rising to 91% for those who have a mental health condition.
Furthermore, 92% of WEA students visit their GP fewer times per year than the national average. We estimate that this saves the NHS at least £1.6m pa.
This suggests that adult learning linked to social prescribing can also, in some cases, divert from the need for medical interventions at an earlier stage. Patients who might present with mild depression or anxiety could potentially find relief through socially prescribed activities, including adult learning.
The WEA has long had connections with health services around the country. We have established a working group to explore how this can be expanded to benefit even more learners and we are in discussion with national social prescribing advocates.
Funding the adult Learning part of social prescribing
Social prescribing is already sufficiently well established as a key part of the NHS Long Term Plan published in 2019. That was also the year that the National Academy for Social Prescribing was established and there are now well over 2,000 link workers.
But we are potentially held back by the emerging funding and accountability framework for adult education which focuses almost entirely on work related outcomes. This framework offers little or no incentive for health and wellbeing related outcomes.
A lifelong learning strategy
A cross-departmental Lifelong Learning Strategy could encourage a more rounded view of what adult learning can offer.
Adult Education is sited within the DfE which may discourage a focus on the wider benefits and outcomes for learning which feel the preserve of other departments such as Health or Culture.
We would like to see the Department for Education – and the Mayoral Combined Authorities which increasingly hold the adult education budget – acknowledging and incentivising health and wellbeing outcomes.
Not only would this have a hugely positive effect for learners, but it could also make significant savings for the NHS in preventative approaches.
Crucially, the new guidance states: “Social prescribing broadens access to the range of support available to people, which may help tackle health inequalities.”
Adult Community Education already makes considerable inroads to tackling educational inequalities, offering opportunities for adults with low or no qualifications and from disadvantaged communities.
As part of a social prescribing programme, it can also become a key component in addressing health inequality – giving support to those who might otherwise be constrained by dependency on prescription medication.
A little spending for larger savings
Spending by one department could deliver large savings for another. A little more spending on adult education for social prescribing could deliver larger savings for our NHS. This is the prize which must be grasped at the Spring Budget.
Simon Parkinson is Chief Executive of WEA