Effective use of data and “solid and sound” accompanying infrastructure could help release some of the pressure on NHS services and save up to eight million GP appointments a year, a new report from the Open Data Institute (ODI) claims. Having adequate data infrastructure in place could help make social prescribing more efficient and in turn free-up NHS primary care resources, including face-to-face GP appointments, the ODI report says.
“If GP appointments fall by 2-5% as a result of social prescribing operating at scale, it could lead to a diversion of between 3.2-8 million GP appointments per year,” the authors write, noting that further research is needed to measure social prescribing’s actual impact on GP appointment volumes.
However, some groups of patients themselves may take some convincing that their data will be protected and used responsibly, particularly as the government seeks to move away from GDPR towards a new and as-yet undefined post-Brexit data regime.
What is social prescribing?
Social prescribing is when GPs and other primary care professionals refer patients to non-clinical support services in the community that can help improve their health and well-being. It is sometimes referred to as community referral and it is based on the theory that people’s health and well-being are determined by economic, social and environmental factors. It is used to support people with conditions such as social anxiety or diabetes by referring them to activities like arts and crafts, outdoor exercise, cookery classes, or gardening.
Although health think tank the King’s Fund quotes studies that have linked social prescribing to the improvement in the quality of life and psychological well-being of those who take part in it, the authors of an article cited in the BMJ said that those studies tended to involve small numbers of participants, lacked comparison groups, and provided little hard data on outcomes.
“[…] Whether social prescribing will curb demand for other primary and community health services is unknown. And there are little or no data on the possible side-effects, either,” note the paper’s authors. “Unfortunately, social prescribing and the individual interventions are still hampered by a lack of robust high-quality evidence of efficacy and effectiveness.”
The need for reliable data infrastructure
Louise Burke, ODI’s managing director, said during ODI’s Summit 2021 on Tuesday that the report highlights the need for “sound and solid” data infrastructure to support the provision of non-clinical interventions. Data infrastructure is made of data assets that are supported by people, processes and technology.
Although social prescribing schemes date back to the 1990s, Burke said that it is a rapidly growing practice within the universal personalised care in the NHS.
“We’ve had calls from GPs and charities and the health sector who all saw the huge benefit to social prescribing,” said Burke. “While it [the report] wasn’t a deep piece of research, you can see from the report that you could actually free up to eight million GP appointments every year where there is a non-clinical intervention required and where social prescribing could be used. This potential actually could help us to cut the backlogs that we’ve experienced as a result of an ageing population and also the pandemic and the pressure that that has put on the NHS.”
Currently, lack of quality data and adequate infrastructure is stifling the potential to deliver social prescribing at a local level that could contribute to freeing NHS resources, said Burke. Timely and ethical data sharing between relevant stakeholders, civil society organisations and the public sector could unleash this opportunity.
Ensuring responsible use of data
Despite the potential benefits that a scaled use of data could bring to improve social prescribing, there are still concerns around the use of healthcare care by the government and providers. NHS Digital plans to collect pseudonymised medical records held by GP surgeries earlier in the year backfired after medical professionals, MPs and privacy groups complained about the lack of communication around the scheme.
A report by consumer rights charity Which? found that 45% of adults in England were unaware of plans to share GP records with the NHS for research.
Dr Milly Zimeta, head of public policy at ODI, told reporters that more mechanisms for building public trust about the use of their data are needed. “The public is not monolithic,” said Zimeta. “There are different ‘publics’ and also the conditions of trust are not static. Our research and our work on data assurance has shown that the conditions of trust are dynamic, relational and they’re context-sensitive.
“I think what we’re going to need to see more of is more mechanisms for building trust and agility to respond to the different needs of different publics with different data use cases.”
Nigel Shadbolt, ODI’s co-founder and executive chairman acknowledged the concerns that some people might have regarding the outcomes of the government’s data consultation launched in September. The document, called “Data: A new direction”, seeks to remove barriers to innovation in current data legislation. However, privacy campaigners and experts have raised concerns about removing certain controls.
Although research organisations such as universities should be able to use data effectively “to answer questions that we all think should be answered”, Shadbolt said privacy impact assessments should remain to ensure transparency.
“It seems to me that the data assurance you need to go through is [to ensure] the data being fed into the algorithms, is in some sense proportionate, representative and has been appropriately anonymised. [These] are still important checks to go through,” said Shadbolt.