Imagine you lived in some remote rural village and you found, after years of searching, an elixir which really helped make people feel healthier and happier. What if the elixir was freely available and all around us? Imagine if that were so but the people in the village didn’t seem to notice it and the village elders chose to focus instead on creating other healing potions that were far more risky and expensive and would not listen to you. Imagine that you carried on nonetheless. Despite being told that you were either visionary, or insufficiently unschooled in the realities of the ‘real world’ to be of value. Yet all the time you could see that the elixir was working and the evidence all around you showed you that? Now imagine that one day you were invited to the capital city to meet with other people to talk about this elixir and found that not only did lots of other people in other places know about it but that they had known about it for years. There were lots of people who could show you exactly why it worked and knew without doubt that people who got access to it lived longer and happier lives. Imagine that the elixir was so accepted that even the man who is next in line to the throne of the Kingdom came to show that to the people there.
This was my experience of going to the Kings Fund Social Prescribing Conference. Everything I have been arguing here for 7 years now was supported by experience and evidence from others. What we were told is that this practice is possible now and has been for years. Those who look after the health of their communities in this way appeared to find it incredible that other GPs were willing to restrict themselves to pills, potions and referrals up the NHS when they could exploit a rich vein of other health giving and wellbeing enhances in the community around them. There was evidence galore that the best doctors are good food, sunshine, rest, exercise and fresh air and these are, largely free. This, to the ears of people round us here, apparently pink and fluffy view is rooted in the hardest possible scientific evidence of the effects of not getting these on the very stuff we are made of our DNA. Deprived of these life giving substances our telomeres become shorter. And the length of our telomeres directly relates to how we age and how long we will live for. More brutally put not being part of the natural environment we were evolved within kills us.
So it is gratifying that others are taking it seriously elsewhere. That there are local authorities who are investing in infrastructure which enables their GPs to socially prescribe and that there is a ever increasingly body of work which shows without question that we need to widen our understanding of how to stay healthy and recover more quickly when they we are injured or ill. That this is a complex process is not in question. We have to turn a system which treats illness to one which invests in health. Most of that investment needs to be made not in institutions but in places where people live and work and out here in the community.
Nor does that investment need to be expensive. Indeed done properly it would save money. However it means starting from a different place and considering first how to make the places where we live and work ones which make it easier for people to be healthy and GPS need to play their role in that. This requires them to work with others outside the medical profession, to invest in understanding (whether collectively or as a group) more about what is happening in their patients local community which, if invested in, would help achieve their health goals. It requires treating us with respect and as part of the solution rather than as none complaint, resource-less dependents who can’t understand and won’t do what we are told. What we need in Liverpool is a shift in the mind sets of those in positions of power and influence and we need it now.