Is prescribing social care the answer to NHS woes?

Perspective
Publication Date
01/12/2021
A person posing for the camera
Caroline Gardner, FCPFA, FRSE; Auditor General for Scotland from 2012 to 2020.

Currently in Scotland, between 25% and 50% of GP appointments focus on non-medical issues, such as social isolation, financial struggles, and bereavement. Social prescribing, also known as community referral, allows GPs, nurses and other healthcare workers to signpost patients to support outside of health services, through community organisations, local support groups and holistic hubs.

If we adopted a social prescribing model in Scotland, we could reduce the intense pressure on health services due to delayed medical procedures and appointments during Covid-19, as well as growing mental health issues fuelled by the pandemic.  

78% of GPs reported prescribing antidepressants to patients, despite believing that an alternative treatment would be more appropriate.

I was chair of the ‘inclusive public service’ working group for the Royal Society of Edinburgh’s Post-Covid-19 Futures Commission, and we published a report in partnership with Support in Mind Scotland (SiMS), urging decision-makers in Scotland to adopt a social prescribing approach to healthcare as a priority.

For our report, we spoke to those who are already delivering, facilitating and accessing support through community referral. One study in the report found that a huge 78% of GPs reported prescribing antidepressants to patients, despite believing that an alternative treatment would be more appropriate. Due to long waiting lists or lack of resources, GPs felt they had no other way to help their patients.

Currently, those who are struggling with mental health problems will likely visit their GP and have a short appointment to talk about their concerns. Resources are stretched, and so they may be added to a waiting list for further treatment or prescribed medication, which may not do anything to help them.

If we adopted social prescribing, the individual would be put in touch with someone in their local area who understands the complexities of their situation and has knowledge of local resources. It may result in matching them with a friend to talk to, or integrating them in a local activity group.

Feedback from those who have accessed social prescribing is positive, indicating that the model is helping to embed community-level, non-clinical and person-centred care. However, there is still more to do to embed these principles into Scotland’s health and wellbeing support systems.

A 2019 enquiry by the Scottish Parliament’s Health and Sport Committee found that social prescribing had considerable potential for preventing long-term conditions and dependence on pharmaceutical prescriptions. Despite this study, the approach has not been rolled out nationally, due to a lack of funding and awareness.

Social prescribing is not a ‘quick fix’ for the issues facing the Scottish public service environment after the pandemic. But, if real leadership, resource and investment is paired with widespread and meaningful change, it could be the answer to providing real relief to our overstretched NHS.


Caroline Gardner, FCPFA, FRSE was the Auditor General for Scotland from 2012 to 2020 and was a member of the Royal Society of Edinburgh’s Post-Covid-19 Futures Commission, which recently published its Reimagining Scotland report.

This article originally appeared in The Times on 1 December 2021.

The RSE’s Perspective blog series offers personal views from our Fellows on a variety of issues. These views are not those of the RSE and are intended to offer different perspectives on a range of current issues.