Non-clinical community interventions: a systematised review of social prescribing schemes

Abstract Background: This review focused on evaluation of United Kingdom social prescribing schemes published in peer-reviewed journals and reports. Schemes, including arts, books, education, and exercise ‘on prescription’ refer patients to community sources of non-clinical intervention. Method: A systematised review protocol appraised primary research material evaluating social prescribing schemes published 2000-15. Searches were performed in electronic databases using keywords, and articles were screened for evaluation of patient data, referral process, assessment method and outcomes; non-evaluated articles were excluded. Results: Of 86 schemes located including pilots, 40 evaluated primary research material: 17 used quantitative methods including six randomised controlled trials; 16 qualitative methods, and seven mixed methods; 9 exclusively involved arts on prescription. Conclusions: Outcomes included increase in self-esteem and confidence; improvement in mental wellbeing and positive mood; and reduction in anxiety, depression and negative mood. Despite positive findings, the review identifies a number of gaps in the evidence base and makes recommendations for future evaluation and implementation of referral pathways

Conceptualising Austerity in Scotland as a Risk Shift: Ideas and Implications

There is growing recognition that UK austerity measures impact adversely and more acutely on the most disadvantaged individuals, communities and groups. These changes may be understood as representing a shift of responsibility away from collectives to individuals. This paper explores these issues through the lens of risk analysis. Drawing on case study research from one neighbourhood in one Scottish local authority, it considers how the distinctive polity in Scotland, in the context of austerity, is redistributing social risk to vulnerable communities, groups and individuals. The local community is adapting, with varying degrees of success, to the risk transfers they are experiencing. Formal and informal risk mitigation measures are ameliorating, but not countering, these risks. The penultimate section of the paper is a collaborative endeavour. Drawing from a seminar discussion with key informants from academia, the Third Sector and government in Scotland, some of the implications of this ‘risk shift’ are discussed; particularly in relation to extending personalisation, stresses on social capital, changing understanding of securities, demographic developments, widening social divisions and alternatives to austerity economics