Social prescribing for frequent attenders: findings from an innovative pilot intervention

Abstract

BackgroundSocial prescribing and use of local resources is emerging as a complementary prescription in meeting health-care demands to address public needs. Frequent attenders are individuals who have, on average, 30 face-to-face consultations with general practitioners (GPs) over 2 years. There is growing evidence of the positive health outcomes of social prescribing, although less is known about the patients that are referred and the economic impact on the health-care system. We aimed to explore whether the participation of frequent attenders in a pilot social prescribing intervention affected their health and wellbeing outcomes and use of health-care resources as a consequence of the intervention. MethodsThis pilot evaluation took a mixed method approach using focus groups, in-depth interviews, and quantitative health and wellbeing data gathered before and after the intervention via self-reported questionnaires (Warwick-Edinburgh Mental Wellbeing Scale). The intervention was delivered via two social prescribers across three GP practices in south Wales, with patients identified as frequent attenders referred to structured volunteering interventions. Participants received time credits in exchange for volunteering. 1 h of volunteering equalled one credit, which could be exchanged for various leisure activities and other opportunities (eg, cinema vouchers). We did a cost analysis to estimate cost variances based on health-care unit usage before, during, and after the intervention. FindingsBetween Sept 1, 2017, and Jan 31, 2018, 78 patients were recruited to the intervention over 5 months, with 21 identified as frequent attenders. Thematic analysis of social prescriber's case notes showed that all patients presented with complex psychosocial, mental, and physical health conditions. Post-intervention, frequent attenders had improved health and wellbeing outcomes and were less reliant on health-care resources (decreased usage of health-care units, GP consultations, and prescriptions issued). Cost variance results show a direct cost saving of £8109 or £77·22 per frequent attender over the 5 months. InterpretationAlthough frequent attenders often have complex, chronic health issues, participating in this innovative intervention had a positive effect on their health and wellbeing outcomes, improved social support, and reduced isolation. Our findings show that social prescribing interventions are a key part of a social model of health and wellbeing in non-clinical support policy development in line with legislative changes. FundingInnovate to Save, Welsh Government.