South Devon Healthcare NHS Foundation Trust has been piloting Reading Well Books on Prescription in their pain clinics; they are one of the first hospital trusts to use the collection in this way. Dr Dee Burrows, Clinical Nurse Specialist in Chronic Pain, took the lead on prescribing the books to patients. The first prescription was offered to patients in March 2014 and the scheme is now promoted via pain clinics in the community and main hospital. Dr Burrows reflects on the pilot to date:
'I am thrilled we tried it'
Reading Well Books on Prescription is currently used by the two pain nurses and our database shows that over six months we have issued more than 40 prescriptions. Whether a patient gets a prescription is reliant on us determining that this is an appropriate treatment option for the person in front of us and them agreeing to it. I have found that patients have been surprised and intrigued by being offered a book 'prescription'; it feels reassuringly 'medical'.
I was previously familiar with giving out prescriptions for exercise, which was what first interested me in the idea of prescribing books. In addition, I have recommended several books on the book list to patients in the past. I was interested to see that the book list included titles about insomnia; people with pain often have sleep problems.
Even as a pilot scheme, Reading Well Books on Prescription has made a difference in South Devon and I am thrilled we tried it. One patient who accessed Overcoming Chronic Pain said she found it helpful and commented that she is now aware that her pain "may well get worse but won't kill" her. She was very interested in the chapter on exercise and was delighted to find that she can still touch her toes, which she demonstrated to me in the clinic. She understands that exercise is safe and requested details about a "sensible exercise" programme. Before being prescribed the book, this lady had a very medical focus; she wanted surgery. She now believes that she can develop self-management skills without having to rely on the NHS.
Self-management for chronic pain
I am an advocate of self-management, which is a core component of the NHS Health and Social Care strategy for people with long-term conditions like chronic pain. People with the condition live with it in the course of their day-to-day lives. They do not spend their time in hospital clinics; rather, clinics provide help with the complex problems. My role is to help people maintain their independence and achieve what they want to at home, work and in leisure alongside their pain. Resources that they can take away and use for themselves are thus very helpful.
Fifty percent of the people we have given book prescriptions to have been discharged at that appointment or the following one. Our outcomes suggest that people given book prescriptions are able to build self-management skills relatively quickly. This approach will not suit all and those who need more complex support will receive it,but there are some who are able to follow their own self-management journey with minimal guidance. Self-help books can help these people move away from anticipation of a cure to learning to live alongside their long-term condition.
There have been challenges; for instance, patients who do not go on to use their prescriptions. It is also vital that people have a positive experience when they take their prescription to the local library. If people are unable to access a book, for instance due to an outstanding fine, it can really set them back and interrupt their commitment to self-management. There are people who, through no fault of their own, develop a chronic condition that can have drastic effects on their income, ability to work and their physical and mental health. Health organisations, libraries and other agencies therefore need to work together closely to support the people we are engaging with via Reading Well Books on Prescription.
'Try it and evaluate it'
My advice to other hospital trusts who would be interested in using Reading Well Books on Prescription would be to try it and evaluate it: hopefully it will prove the right approach for some of your patients and will give you another option when working with people with pain and other long-term conditions.
Find out more about Reading Well Books on Prescription