Is exercise the best medicine? This thought provoking article published recently in The Times leaves us with food for thought. When treating patients, have we become too reliant on prescribing medications? Are these drugs effective? Or are other forms of treatment more effective? For example, in the treatment of back pain, recent research has shown that gentle and regular exercise is a far more effective than NSAIDs and painkillers.

As outlined in the article, social-prescribing may indeed be more beneficial for some people. Health aspects to one side, this approach has achieved other positive results. That said, the NHS’ shortcomings are well-documented. While such schemes would be welcome, are there sufficient resources and funding available in order to be able to implement them on a nationwide basis?

Originally published in The Times on Friday September 7 2018

A twirl around the dance floor is the best medicine, NHS bosses told

by Chris Smyth, Health Editor (The Times)

Prescribing ballroom dancing, gardening or cookery classes can be better for patients than medicine and the NHS must make it routine, the health secretary has said.

As he set out plans for technology to transform the NHS, Matt Hancock said that wearable monitors such as Fitbits could send data to GPs so that they could remind people who were not getting enough exercise. While speaking of “clunky” computer systems in the NHS, which he called “the world’s most frustrating place to work for its IT”, he said that he was a “big fan of social prescribing”, in which GPs refer patients to yoga classes, history clubs and other non-medical groups.

ARE SOCIAL ACTIVITIES MORE EFFECTIVE THAN MEDICINES?

“The evidence increasingly shows that activities like social clubs, art, ballroom dancing and gardening can be more effective than medicines for some people and I want to see an increase in that sort of social prescribing,” he said.

Mr Hancock said that he would help NHS staff who wanted to provide care by asking their patients to engage in the community, become active and join groups “as well as – or sometimes rather than – taking medicine.”

He added: “I think there is a growing evidence base that social prescribing can be better for patients than medicine. Of course there will also be medicine prescribed, and rightly so, but I want to see the balance shifted in favour of social prescribing.”

GPs to use more social prescribing for patients with mental-health conditions?

Mr Hancock told The Times soon after taking over as health secretary in July that he wanted GPs to use more social prescribing for patients with mental-health conditions. Yesterday at the Health and Care Expo in Manchester he said that there was “no reason why this is not something that could happen right across the NHS”.

Such schemes are more organised than simply suggestions that people get out more, he insisted. “My wife regularly tells me to do more exercise but what I really care about is ensuring that within the NHS it is normal practice to consider a formal social prescription and that the growing evidence base for the value of social prescribing is taken on board by practitioners,” he said.

An overview if research last year concluded that social-prescribing schemes could help to cut A&E visits by a quarter while also reducing hospital admissions and GP appointments. Each £1 spent on social prescribing could save £2.30 by improving health and helping people back to work, research by the University of Westminster estimated. Others have criticised the quality of research into social prescribing.

The role of technology in social prescribing?

Mr Hancock said that technology could help social prescribing, for example by linking data from wearable devices to NHS records, which could then send alerts if people’s activity levels dropped. “There is growing evidence that reminders are an important part of making sure medicines or social prescriptions work,” he said, adding that such devices could “prevent the need to see the doctor in the first place” by keeping us healthy.

“The device that measures and celebrates when you go for a run, the gentle reminder to set sleep patterns… can support prevention and help us all manage our health like we do our finances,” Mr Hancock said.

SOCIAL PRESCRIBERS IN EVERY GP SURGERY?

Professor Helen Stokes-Lampard, chairwoman of the Royal College of GPs, wants every surgery to have a dedicated social prescriber. “Often, the underlying reason for a patient visiting their GP is not medical despite their initial complaints seeming to be of a physical nature, and in some of these cases ‘social prescribing’ can be more beneficial for a patient than prescribing them medications or other conventional treatment,” she said.

“This might include a recommendation to an activity, advisory service, course or community group, either instead of or in conjunction with traditional medicine – whatever is most appropriate for the individual patient.”