Helen Stokes-Lampard: Social prescribing and the current NHS landscape

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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.

Transcript

I’m a real GP, I see patients in my practice, and I regard that as the most important thing that I do. I use a metaphor to describe general practice as a three legged stool.  And the three legged stool of general practice is the physical problems that our patients have accompanied by the social problems they face, and their psychological wellbeing.  That three legged stool will not stand up and carry general practice and carry the NHS if it is not evenly balanced.  General practice is about providing holistic care to our patients, and today over £1 million consultations will take place in general practice in the UK.  General practitioners are consultants in general practice, we are expert medical generalists trying to bring the whole plethora of these issues together in the best interests of our patients.  And we do that best when we’re in an environment that’s adequately resourced and adequately staffed.  The Royal College of GPs, the largest of the medical colleges representing 52,000 or more than 52,000 doctors around the UK, we believe in working in partnership with our patients, we believe in the delivery of holistic generalist care providing equitable access to and delivery of high quality, effective primary care for everybody.  But our campaign priorities this year include campaigning obviously for resource staffing money, all that stuff, but actually a lot about workforce.  Recruiting, retaining within the workforce, bringing back to the practice clinicians, and this is not just GPs, this is about the wider primary healthcare team.

I regard general practitioners as conductors of an orchestra of colleagues in the community who are working together for the best interests of our patients. We know, and I’m sure we will hear a lot today, but in areas where social prescribing is used, the clinicians are more resilient, they are better able to carry on doing their jobs, they are more satisfied in their jobs, the patients are happier and better.  And ultimately that is turning into tangible benefits for the whole of society.

Workload is unquestionably helped by the use of social prescribing. To be a primary healthcare professional should be a joyful thing to do.  We have the most phenomenal jobs in terms of satisfaction and personal, professional reward.  However we are a very demoralised time and an understaffed and under-resourced environment.   Social prescribing, if all it did was help with joy I would welcome it, we know it does far more.  When I start talking to colleagues about social prescribing, they say to me ‘That’s nothing new, that’s what good GPs have always done’.  And I come back ‘Yes but we’re doing it bigger and better, scaling up, using other colleagues to help us’, because I don’t know about you, but I can’t keep in my head more than 40 or 50 organisations in my community to tell my patients about.  My notice board is covered in contacts and leaflets and bits of paper of places that I send my patients.

There is a caveat however, I’m not just here to be all smiley and happy and say it’s wonderful. And our concern at the moment is in a stressed environment, people will see this as great the GP is going to do it all, general practitioners and their teams will do it all and take responsibility from other areas in society.  And there is a balance here and it has got to be tailored to the local environment.  There will always be ostriches when it comes to anything, people who have their heads in the sand.  And do you know what, I’m not worried about the ostriches.  One day they will take their head out of the sand and they will run and catch up, ostriches do have long legs as it happens.  This room, this building, is full of the visionaries, those at the other end of the spectrum, those who get this, those who see where we’re going with this.  In the middle however I would say are still the majority of general practitioners and their teams who think it’s a nice idea.  It’s intuitive, it’s a bit motherhood and apple pie.  Once you know what it is, why wouldn’t we all be doing it?  However GPs and their teams don’t quite know where to start, they need a helping hand, they need some exemplars.

For me, I want to help turn on the lights, so they’re stepping into the lights, not taking a leap into the dark with social prescribing. General practice is evolving and changing.  We’re working in larger groups and organisations to protect us.  There are a wider variety of healthcare professionals working alongside GPs.  I talked about that orchestra of primary care, making beautiful music takes lots of different elements, lots of different people.  This should allow GPs to have longer time with patients with complex conditions, with multiple conditions, multiple prescribing needs multiple issues.  And to allow one of the key things to help free up some of our time is where social prescribing really should come into its own, to take some of that stuff away from GPs to give us the time to concentrate on the stuff that only the GP can do.

So I believe social prescribing should become a normal part of what good primary care looks like. General practice is evolving, but we’re all on a journey, it’s really exciting.  And don’t forget that spectrum, you are the visionaries at one end of the spectrum, help those in the middle, flick the light switch, help them into the light, don’t make them feel they’re stuck in the dark.  Thank you very much.

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