Wellbeing: The new pill-free prescription
Come spring, the first thing that patients see as they walk into the College Surgery in Cullompton, Devon, are the green shoots of a raised-bed vegetable garden beside a physic garden full of healing herbs. Dr. Michael Dixon explains that they are tended by the surgery’s gardening club, one of the social prescribing initiatives set up by the dozen GP partners in the practice and run by volunteers.
‘Gardening ticks all the boxes,’ says Dr. Dixon. ‘Contact with nature is healing in itself and growing food to eat teaches patients about the health benefits. Even fussy children can’t resist carrots and cabbages they have planted. People get a sense of achievement when they have grown something, which contributes to self-worth.’ Other options at College Surgery include a walk-and-talk group, knit-and-natter club, seated exercise class for people with disabilities and yoga for babies.
In 2016, Dr. Dixon was appointed NHS England’s national clinical champion for social prescribing, which aims to improve patients’ health by non-medical interventions, usually provided by voluntary, community and charity organisations. Like 100 or so GP practices nationwide, College Surgery had used this approach for several years, but until Dr Dixon’s appointment there had been no cohesive network.
Social prescribing embraces a wide range of activities, from gardening, cookery, sports, art classes, dancing, knitting and fishing clubs to help with finance. In Halton, Cheshire, GPs offer Nordic walking and line dancing on prescription, along with confidence and stress management classes.
Typically, the GP refers a patient to a link worker (College Surgery has one in the practice), who spends time with the patient talking about their situation and, crucially, what they can achieve rather than what they can’t. There is a strong focus on the social side: ‘Our fractured modern society has created an epidemic of soul-destroying loneliness, which causes as much illness and premature death as heavy smoking,’ says Dr. Dixon. ‘Simple measures can reduce isolation and help rebuild a sense of community with quantifiable benefits to health.’
At the moment, half of pensioners take at least five drugs daily, more than four times the level 20 years ago; antidepressant prescriptions have more than doubled in a decade and reliance on over-the-counter painkillers has risen by 40 per cent. Recently, Simon Stevens, head of the NHS, urged GPs to consider social prescribing ‘rather than a pill for every ill. For people who are stressed or depressed, who have chronic pain or other long-term health problems, social prescribing is often worth trying either in place of drugs or alongside usual care.’
Health experts have described the potential of social prescribing as transformational. Already, research has found that such interventions can cut GP visits and trips to casualty by more than a fifth. And at a time when family doctors are under greater pressure than ever, ‘it helps make GPs’ workload more manageable and effective’, says Dr Dixon. And at College Surgery there are also fresh salads for lunch.
RETHINK PINK this spring for Breast Cancer Now. Like exercise, gardening can help to reduce the risk of breast cancer so Town & Country has joined forces with the charity to donate ten per cent of the price from its new gardening tools to Breast Cancer Now (breastcancernow.org). I like the well-designed bamboo gloves/£4.99, secateurs with comfy soft-grip handle/£7.99) and useful pouch/£12.99, all from townandco.com).
HOW TO AVOID GARDENER'S BACKACHE
If, like me, you love gardening but sometimes end up achy, chiropractor Dominic Cheetham offers these simple tips:
● Warm up with gentle stretches before you start.
● Invest in specialised tools with long handles and do all the fiddly things such a spotting on a table.
● Wear supportive footwear and no tight belts or jeans.
● Bend your knees, not your back. Use a kneeler or knee pads.
● Take breaks every 20-30 minutes and vary your activities.
● Do the opposite action: if you have been bending forwards, eg, digging, stretch your whole body up and back with arms out.
● Don’t flop down afterwards – stretch gently, then have a warm bath with Epsom salts.