Social prescribing in very deprived areas

Abstract

PILLS'Social and medical problems are often not differentiated by patients who look to GP practices for help.Many patients present with concerns that arise from their social situation, and the management of long-term medical conditions is often affected by personal circumstances.Doctors need to be able to respond to this wider picture.Indeed, the extent to which doctors are able and willing to take into account their patients' daily lives and concerns is seen as a key element of good quality medical care by patients who live in socially deprived areas. 1 Many GPs develop some knowledge about resources outside of the health service that can assist patients; for example, with financial problems, domestic violence, or housing issues.Some GP practices also work with outside groups to promote or plan local resources.This practice of signposting patients to nonhealth service resources has been labelled 'social prescribing'.Ten GPs, working among some of the most deprived patient populations in Scotland, took part in a small study to examine the extent to which social prescribing forms part of their clinical work.Two major themes emerge from this reflection.The first is their awareness of the disabling impact of government policies.The second is their aspiration to emphasise the strengths of patients themselves to tackle their own problems.The GPs who took part are aware of the problems that many of their patients face: low pay, alienating work conditions, low expectations, poor educational achievement, ready access to drugs of addiction including alcohol and tobacco, worklessness, poor nutrition, and poor physical and mental health.Many of these factors are intergenerational and affect children from the earliest age. 2 They point out that rationing on medical grounds of resources, including benefits and housing, emphasises disability.Personal anxieties and social problems are repackaged as medical problems, such as mood disorder or chronic pain.For many patients this appears to be the only channel available by which to struggle for selfbetterment.GPs are concerned that doctors' reports provided in response to requests to prove

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