How do you solve a problem like the health service? In Northern Ireland, it seems like we’ve spent the last ten years publishing reports on this intractable issue.

The central problem is a demographic one. Our population is ageing quite rapidly, and the train shows no signs of slowing down; over-65s are expected to outnumber children during the next decade, with the over-85 population set to grow by 120% by 2040.

The fact that we are all living longer is something the health service should be immensely proud of, but there are enormous demands being placed on services as a result. GP surgeries are hitting crisis points, attendance at A&E is increasing and the worsening situation with waiting lists recently forced the Department of Health to divert £30m from transformation funding to try and stem the tide.

These demands are directly linked to our demographic trends. According to one report from a panel of international experts: “This increase in life expectancy is a great achievement, but it signals a major shift in demography and in patterns of demand for health and social care services. Ageing brings an increased likelihood of some degree of disability, dependency and illness, and older people are now the main users of Northern Ireland’s health and social care services.” 

Those who would seek to address the problem with more money should remember that the health service already accounts for nearly half of the entire Northern Ireland budget, and spending on health, per head of population, has increased by nearly 60% here in real terms since the turn of the century.

Resources are definitely important, but the key to creating a better system in the long term is transformation and innovation. This is where we should be carving out a role for social prescribing.

The King’s Fund defines social prescribing as “a means of enabling GPs, nurses and other primary care professionals to refer people to a range of local, non-clinical services… to address people’s needs in a holistic way [and] support individuals to take greater control of their own health.” It is a preventative concept which recognises that poor mental and physical health, isolation and loneliness – which may all affect older people – can exacerbate pre-existing health issues and make the patient’s condition worse.

The aim, then, through increasing access to care and support in the community setting, is to prevent further deterioration of people with long term conditions/disabilities and reduce the need for specialist interventions.

Patients may be ‘prescribed’ activities like exercise classes, writing workshops, men’s sheds or lunch clubs, to name a few. In improving people’s physical health and mental wellbeing, they enjoy a better quality of life and don’t need to use primary health services as much.

In Northern Ireland, great work is this area has begun in places like the Western Health Trust, but social prescribing is still quite a new concept. Evidence from elsewhere suggests it can make a real difference.

In 2013, the Compassionate Frome project was launched in Somerset – aiming to combat isolation and associated mental health issues within the local population. Health connectors were employed to refer patients to support from local community groups. During a three-year study of the project, emergency hospital admissions rose by 29% across the whole of Somerset, but fell by 17% in Frome.

Elsewhere, in Rotherham, a social prescribing scheme was set up between 2012-2014 to connect patients to support from more than 20 local voluntary and community sector organisations. A study of the scheme showed that, for more than 8 in 10 patients who were followed up three to four months after being referred, there were reductions in A&E attendance, outpatient appointments and inpatient admissions.

These are just two examples, and there is more research to be done on the effectiveness of social prescribing on a wider scale. But the evidence so far looks good, and moving forward in Northern Ireland, we should certainly be taking the role of social prescribing seriously in all public conversations about improving the health service.