Your licence empowers you to socially prescribe BALM to patients and is subsidised by the Sourdough Club Social Enterprise Funds.
The prescription licence is a significant part of our systems change program and is heavily subsidised to help actualise our vision. For over 20 years, we’ve remained committed to helping people live the best lives they can through baking as lifestyle medicine. This approach is transforming the way we perceive health and wellbeing, effecting changes within the NHS and society as a whole.
Throughout the years, we’ve taught thousands of people how to integrate baking as a lifestyle medicine into their lives, enabling them to consume more fibre, access greater nutrition, and reduce their risks of diseases such as bowel cancer, Alzheimer’s, and cardiovascular disease, all the while nourishing their gut microbiome. This licence programme is the embodiment of that mission, empowering our graduates to carry forward this work and impact their patients similarly.
As a part of our social enterprise, our graduates can invite their patients to participate, join a community, and find a purpose. This is a social justice system built to address the complexities of people’s lives, as well as the inequalities they may face. And at the core, it’s about baking delicious, nutritious, affordable bread that nourishes both body and soul.
We have created the BALM social prescribing to help manage these complexities and to make a difference. Welcome to our journey of transformation through baking – we hope you love it as much as we do.
1.0 Agreement for Licensing Prescription and Prescribers’ Licence Fee Structure
This agreement represents a licensing prescription awarded by The Sourdough School Ltd and the vouchers provided by The Sourdough Club Ltd. The Licensee is a graduate of the Sourdough School Baking as Lifestyle Medicine (BALM) Diploma and has successfully completed both the Practical and Clinical Modules.
The Licence Fee and Alumni Membership fees are separate and independent of each other. The Licence Fee grants the prescribing authority, while the Alumni Membership ensures continuous professional development and access to resources.
1.1 Annual Licence Fee:
The annual licence fee for BALM Graduates is £299. This fee covers our administration and creation of vouchers and contributes to the running of the programme. It grants graduates the authority to prescribe up to 12 Social Prescriptions Memberships per year to eligible patients. These memberships provide access to our services at a heavily discounted rate allowing patients to benefit from the therapeutic benefits of baking as a lifestyle medicine.
1.2 Monthly Fees & Benefits of Licence:
In addition to the licence fee, graduates are required to maintain an active Alumni Membership. The Alumni Membership is priced at £21.99 per month. This membership ensures that graduates stay updated with the latest findings, research, and developments in our field. It also contributes to the ongoing operation and sustainability of our club.
The Licensee is responsible for the timely payment of the Licence Fee and maintaining an active Alumni Membership throughout the duration of their participation as a prescriber in the BALM Programme.
Please note that failure to fulfil the payment obligations may result in the suspension or revocation of the Licensee’s prescribing privileges.
As a Licensee of The Sourdough School and Sourdough Club:
- Continued Learning: Licensees are granted ongoing participation in live diploma sessions. This means that the learning and professional development does not end once the diploma is achieved; it is an ongoing process.
- Access to Resources: Licensees will retain access to all the libraries and protocols from their diploma course for the past two years, including any new material added after the completion of their course. This ensures that Licensees remain up to date with the latest developments in the field.
- Prescribing Sessions: On a monthly basis, a two-hour prescribing session is held for Licensees. Attendance is optional but recommended as these sessions provide valuable updates and insights.
- Community Participation: Licensees can remain in the diploma forum and participate as alumni. This is an opportunity to engage with current students, share experiences, offer support, and continue to learn from the community. The forum serves as a platform for networking and continued professional development.
Please note that these benefits are conditional upon the continued adherence to the terms and conditions of this licence.
1.3 Number and Value of Vouchers
Upon receiving their licence, each graduate is granted subsidised vouchers which allow them to issue twenty-four social prescriptions as the following discounted memberships:
1.3.1 Social Prescription Memberships
Graduates may prescribe Social Prescription Memberships, normally valued at £491.88 each (£299 registration fee + £15.99 monthly tuition for 12 months), at a discounted rate of £33.87 each (£9.99 registration fee + £1.99 monthly tuition for 12 months). Thus, each graduate has the potential to prescribe up to twelve memberships, totalling a value of £5,496.12 in discounts per annum.
1.3.2 Socially Discounted Club Memberships
In addition, graduates can prescribe Socially Discounted Club Memberships, also normally valued at £491.88 each, at a reduced cost of £109.87 each (£49.99 registration fee + £4.99 monthly tuition for 12 months). This gives the possibility for each graduate to prescribe up to twelve memberships, equating to a value of £4,584.12 in discounts per annum.
1.3.3 Total Value
As such, each graduate, through the use of these discounted memberships, is providing a total value of £10,080.24 (£5,496.12 from Social Prescription Memberships + £4,584.12 from Socially Discounted Club Memberships) in discounts to their patients annually.
1.3.4 Terms of Use
As part of their agreement, graduates must utilize a minimum of 50% of these vouchers each year. Failure to do so may result in the refusal of licence renewal. This term is integral to the ethos of our systems change programme, underscoring the commitment of each Licensee to act as a change activist, driving social and behavioural change through the power of social prescribing. Limitations apply to the number of licenses issued, thereby ensuring the integrity and impact of our programme.
1.4 Issuing of Vouchers
1.4.1 Voucher Provision
Upon granting of the licence, BALM will issue a set number of vouchers to each Licensee. The vouchers will be in a physical format that the Licensee can give directly to their patients. This is a simple and effective way to protect patient information as there is no communication via email.
1.4.2 Confidentiality and Use
The physical voucher maintains a strict separation between The Sourdough Club, The Sourdough School Ltd and the patient, ensuring confidentiality. The patient can take the voucher home, consider if they want to join the Club, enter the URL provided into their computer, and if they so wish they can redeem their voucher. This process ensures patient confidentiality is respected, and as we issue many vouchers ourselves, we are not privy to the patient’s identity, and there is absolutely no difference in the memberships of a socially discounted membership, to a standard membership – they are the same.
1.4.3 Future Digitalisation
The Sourdough School and Club are actively considering methods for digitalising the voucher system, including the potential development of an app or a secure online portal to deliver BALM. In the interim, BALM will provide an email template in the Syllabus and email codes for Licensees who wish to issue vouchers digitally. You will need to keep a professional BALM record of your patients and vouchers and dates of issue as part of your practice, which allow you to follow up. This allows remote patients to receive and utilise the vouchers while maintaining patient confidentiality.
The email template will contain a brief explanation of BALM, instructions on how to redeem the voucher, and a placeholder for the unique code. Licensees will receive these unique codes from BALM in a secure manner. Licensees are obliged to adhere strictly to patient confidentiality requirements during this process.
Please note that these practices will be updated as necessary to ensure they remain compliant with the latest guidelines and best practices for patient confidentiality and data protection. Licensees will be informed of any changes or new methods implemented.
2.0 Respecting the Separation of Operations for Safeguarding and Confidentiality
Licensees must not join the Sourdough Club. To uphold the highest standards of professionalism, patient confidentiality, and privacy for both our patients and our Licensees, The Sourdough School Ltd and the Sourdough Club have been established as separate legal entities. Each operates independently with its own databases and websites.
This deliberate operational separation is essential to the Programme’s successful and ethical implementation. It is designed to eliminate potential confusion or conflict of interest. Each entity has distinct roles and responsibilities:
- The Sourdough School Ltd: This entity provides comprehensive training and courses for our Licensees. It oversees the education of Licensees to ensure they are equipped with the necessary skills and knowledge to prescribe baking as a lifestyle medicine effectively and safely. Additionally, the licence to prescribe under the Programme is awarded by The Sourdough School Ltd.
- The Sourdough Club Ltd: This entity is responsible for issuing vouchers to patients and managing the patient membership of the Programme. It handles all patient-related operations, including the processing of vouchers and managing patient memberships.
This distinct separation of responsibilities ensures that each entity focuses on its core functions, significantly enhancing the protection of sensitive information. As a Licensee, your interaction with The Sourdough School Ltd is completely separate from the patient interactions handled by The Sourdough Club Ltd, providing an additional layer of privacy and security. You are requested, (unless you are specifically part of the Sourdough School team,) not to join the Sourdough Club. This separation is key to preserving patient confidentiality and the legal separate companies have been structured to safeguard your professional integrity.
This operational separation is central to our commitment to preserving the trust and confidence of our Licensees and our patients. We believe that this clear segregation of roles and responsibilities plays a critical part in the Programme’s success and the well-being of all involved.
3.0 Limitations and Restrictions
The Licensee agrees to use the BALM prescriptions responsibly, prescribing them to patients who could benefit medically from participation in the BALM Programme and who may not typically have access to such resources due to socioeconomic factors.
3.1 The Licensee May/must Take into Account Patient Requirements When Prescribing
Before prescribing BALM, Licensees must verify that their patients meet the following criteria:
- Internet Access and Device: Patients must have access to a suitable device with an internet connection. This is necessary for online registration and for viewing the educational tutorials.
- Kitchen Facilities: Patients need access to a kitchen equipped with an oven, which is essential for baking.
- Baking Equipment: Basic baking equipment, including a bowl, a wooden spoon, and a bread tin or ovenproof dish, is required.
- English Language Proficiency: As our courses are currently only available in English, a good command of the English language is necessary for patients to understand and follow along with the tutorials.
3.1.2 Appropriate Patient Profiles for Social Prescriptions
Graduates may find the BALM approach beneficial for patients presenting with a range of medical or psychosocial conditions. In accordance with the principles of Lifestyle Medicine, guidance in the Syllabus, and training from the Licensee’s diploma of when best to prescribe BALM protocol, such patients may include, but are not limited to, individuals with:
- Irritable Bowel Syndrome (IBS).
- Cardiovascular diseases.
- Chronic constipation.
- Symptoms indicative of social isolation.
- High stress levels due to life events (e.g., grief, menopausal transition, life stressors).
- Mood disorders including depression and anxiety.
- Blood glucose dysregulation (e.g., pre-diabetes, insulin resistance).
- Obesity or weight management issues.
- Situational challenges such as parenting difficulties, caregiving stress, or dealing with adolescents’ issues.
- Any other medical or psychosocial conditions where the Licensee perceives that the BALM approach could provide therapeutic benefits, such as chronic loneliness.
- Individuals with mild cognitive impairment (MCI) or early-stage dementia, as participating in baking activities could help stimulate cognitive functions and provide a sense of accomplishment.
- Persons with Chronic Fatigue Syndrome (CFS) or Fibromyalgia as baking could serve as a therapeutic activity.
- Individuals in recovery from addiction, where baking could serve as a mindful activity contributing to their recovery process.
- Patients with sleep disorders, as the grounding and relaxing nature of baking might aid in establishing better sleep routines.
- Carers looking after a patient with cancer or the patient themselves.
- Patients at risk of bowel cancer, as the extra fibre in BALM is clinically shown to be protective.
- Patients with Inflammatory Bowel Disease (IBD), subject to following the strict guidelines on retarded wholegrain and the 12-week introduction of wholegrain protocol to ensure that gluten is broken down, reducing potential inflammation from unfermented gluten.
Please note that all the above suggestions are subject to the suitability and discretion of the Licensee. It is crucial that the Licensee rules out any health issues that might be exacerbated by the BALM approach. The Licensee should ensure that the BALM methodology will be beneficial to the patient and not aggravate any pre-existing conditions.
If you are a non-medical prescriber, then we recommend that you prescribe in consultation with a medical professional in case of doubt.
3.4 Role of BALM in Conjunction with Traditional Medical Treatment
3.4.1 Complementary Role of BALM
The BALM approach is not intended to replace conventional medication or therapies. Instead, it should be viewed and used as a complementary therapy alongside traditional medical treatments. The goal of BALM is to improve patient well-being and help manage symptoms in tandem with existing medical plans.
3.4.2 Responsibility of the Licensee
Licensees have the responsibility to carefully monitor their patients, particularly those on medication for conditions such as blood sugar dysregulation or chronic constipation. As patients’ health improves, their medication may need to be reviewed and possibly adjusted by their primary healthcare provider. It is crucial that Licensees communicate this to their patients and liaise with other healthcare professionals as needed.
3.4.3 Patient Expectations and Education
Patients should be informed about the potential changes they may experience when incorporating BALM into their lifestyle. This includes an increase in dietary fibre which may lead to some initial flatulence, larger and more frequent bowel movements – all of which are normal. The Licensee must ensure that patients understand these changes and remain motivated and comfortable throughout their journey.
3.4.4 Hydration
Given the increase in fibre intake, it is critical that Licensees advise their patients on the importance of staying well-hydrated. Insufficient water consumption can lead to constipation, particularly with a high-fibre diet. Patients should be encouraged to drink ample amounts of water daily to support optimal digestive health and prevent discomfort.
3.4.5 Medical Monitoring
Regular medical monitoring is key when integrating BALM with traditional treatments. Licensees should advise patients to maintain regular communication with their primary healthcare providers. Any significant changes in health or discomfort should be reported immediately to their medical professional.
By agreeing to these terms and conditions, the Licensee confirms their understanding and agreement to fulfil these responsibilities.
3.5 Age Restriction and Patient Safety
3.5.1 Age Restriction
BALM prescriptions are designed for adults and cannot be directly prescribed to minors (in the UK, individuals under the age of 16). This restriction is due to payment processing requirements, as well as safeguarding considerations. As our community comprises members from around the globe, we cannot guarantee the safeguarding of minors within the digital environment.
However, the BALM approach can be beneficial for teenagers under the supervision and consent of a parent or guardian. In such cases, the parent or guardian assumes the responsibility of managing the membership and guiding the minor in BALM activities.
3.6.2 Patient Responsiveness
Licensees must monitor their patients’ responses to the BALM approach. If a Licensee observes that a patient is not responding well or experiencing adverse effects, they are obliged to recommend discontinuation of the BALM social prescription. Patient health and safety must always be the primary concern, and Licensees are expected to always act in the best interests of their patients.
Failure to adhere to these age restrictions and patient safety requirements may result in non-renewal of the licence.
The Licensee bears the responsibility of ensuring the suitability of the BALM approach for their patients, including adherence to the above criteria.
4.0 The Licensee Must Follow the BALM Social Prescription Invitation Procedure
The Licensee shall invite the patients to join the Sourdough Club by extending an invitation using the recommended approach to prescribing and agree to use empowerment language to communicate that BALM is part of the patient’s treatment plan. They must make clear that the invitation is an offering for the patient to consider and is not mandatory. It does not replace conventional treatments and the Licensee must respect the patient’s autonomy and decision regarding the acceptance of the invitation.
4.1 Checking There Are Two Codes and Giving the Prescription Vouchers
Upon the verbal acceptance of the invitation, the patient may be given an invitation in the form of a voucher for a reduced-rate membership to The Sourdough Club. The Licensee should ensure that the patient is given the prescription with the two voucher codes which will allow them to create a Sourdough Club membership account online. One code is for the registration fee and the second code is for the reduction of the monthly fees.
4.2 The Patient Must Be Informed that the Voucher Code Should Be Kept Confidential
The code is unique to the Licensee and the Licensee should ensure that the patient understands the prescription is only to be used by the designated patient and membership willed to be activated within 14 days of issue.
5.0 Licence Restrictions
The Licensee must not prescribe to individuals with coeliac disease, wheat-induced asthma, wheat allergies, severe mental health conditions, any severe allergies or intolerances related to ingredients used in BALM recipes, or any other condition that may put the individual’s health at risk when participating in the BALM activities.
6.0 Patient Confidentiality
6.1 The Licensee must not inform the Programme about the identities of any of their prescribed patients. Whilst Licensees may discuss concerns or request support in the live sessions, they are required to refrain from using names or any identifying details of a patient if discussing BALM with the team. The Programme will, however, keep the Licensee informed on how many of their vouchers have been used. Patient confidentiality is of utmost importance and must be respected at all times.
6.2 In accordance with the UK Data Protection Act and GDPR, the Programme is unable to confirm whether a patient has joined the Club. It is for the patient to confirm directly with the prescriber should they wish to do so.
7.0 Professional Liability Insurance
Licensees under this agreement are obligated to maintain valid and sufficient professional liability insurance. In the case of practitioners who are part of a recognized institution such as a GP practice or hospital, the insurance provided by the institution will be deemed adequate. However, for private practitioners, it is imperative that a copy of their current professional liability insurance policy be submitted to the Programme as a part of the application process. The absence of such an insurance policy can lead to the refusal or revocation of the licence granted under this agreement.
8.0 The Sourdough School obligations ensure your continued professional development and support
8.1. The Sourdough School and Sourdough Club Responsibilities
8.2 Up-to-Date Protocol and Research
The Sourdough School commits to maintaining up-to-date knowledge and application of evidence within the field of nutritional psychiatry. Our protocols and training materials are regularly reviewed and updated to reflect the latest scientific findings and best practice recommendations.
8.3 Nutritional Psychiatry
The Sourdough School recognizes the value and potential of nutritional psychiatry as a non-invasive, accessible treatment with minimal side effects. As part of this commitment, we pledge to stay informed about ongoing clinical trials and emerging evidence in the field of nutritional psychiatry.
8.4 Team Training
The Sourdough School guarantees that all our team members are fully trained in the BALM Protocol, ensuring they have the knowledge and skills to support Licensees effectively.
8.5 Recipe Compliance
The Sourdough Club is committed to ensuring that all our recipes comply with the structure of BALM. We strive to offer a variety of recipes that support the principles of nutritional psychiatry and lifestyle medicine.
8.6 Lifestyle Medicine Compliance
The Sourdough School is committed to adhering to the six pillars of lifestyle medicine as determined by the British and American Societies of Lifestyle Medicine. These pillars include:
- Healthful eating
- Regular physical activity
- Adequate sleep
- Stress management
- Avoidance of risky substances
- Healthy social interactions
We ensure our training and BALM protocol align with these pillars fostering holistic health improvements for patients.
As a part of your commitment to this Programme, your attendance at live support sessions, held on a monthly basis, is required. These sessions are instrumental in offering continuous professional development, fostering a sense of community amongst Licensees, and ensuring you remain updated on Programme advancements and practices.
8.7 We Agree to Keep You Up to Date
The Sourdough School and Sourdough Club are responsible for the provision of the Research Library. This invaluable resource comprises a comprehensive collection of academic references pertinent to the BALM Protocol, nutritional psychiatry, and lifestyle medicine. Furthermore, we undertake the responsibility of interpreting and integrating up-to-date and relevant research into the recipes and techniques use to teach BALM Protocol. In this manner, we facilitate evidence-based practice and assist in the deepening of understanding regarding the principles and health benefits associated with BALM. If you have any questions about new research, we will research and incorporate it into the supporting knowledge libraries.
9.0 Patient Engagement and Support
The Licensee’s role extends beyond prescribing; they have an obligation to encourage and support their patient’s active engagement with the Programme. This responsibility is central to the success of the Programme’s implementation and its impact on the patient’s well-being. The prescription is part of a supportive club, which will not terminate until the patient chooses to leave. This arrangement empowers both you and your patient, and it is your responsibility to inform the patient of this ongoing support.
As part of this support process, Licensees are required to:
- Provide each patient with a 12-week self-assessment form and advise its completion and return after this period for review.
- Clarify that the provided voucher is personal and non-transferable. It should not be shared with family members or friends; it is specifically tailored to the patient’s individual needs.
- Collaboratively select three symptoms with the patient – one from each category: mental health, physical health, and digestive health. If other specific symptoms or situations arise that you both agree might improve with baking as a therapy, these can also be considered.
- Initiate the process by recording the patient’s start date, blood pressure, weight, and where applicable, cholesterol and blood sugar levels.
- Repeat this process at the end of the 12 weeks to evaluate any changes and assess the impact of the Programme on the patient’s health.
- Give the patient a voucher for kit and or ingredients, if they have requested vouchers and feel this is appropriate.
- Safety and Emergency Protocols
In case of a patient self-scoring poorly (1 or 2 in the score on any symptom), they must report back to their medical provider. This is especially important for mental health. If a patient expresses suicidal thoughts or demonstrates signs of severe mental distress, the Licensee must guide the patient as they prescribe and advise them to seek immediate professional help.
- Dispute Resolution
In the event of a disagreement or dispute arising from or related to this Agreement, the parties shall first attempt to resolve the dispute informally through good faith negotiations. If the dispute cannot be resolved through negotiation, either party may request to engage in mediation.
If the dispute is not resolved through negotiation or mediation, it will then be referred to and finally resolved by the courts of [Jurisdiction]. The parties hereby agree to submit to the exclusive jurisdiction of these courts.
- Breach of Agreement
If a Licensee is found to have violated any terms of this Agreement, the Programme reserves the right to take appropriate action. Please note, however, that a breach of patient confidentiality may have additional consequences under applicable professional regulations and laws and could result in legal action. Breach of patient confidentiality represents a severe violation with far-reaching implications. Breaches of this nature not only contravene this Agreement but also infringe upon professional regulations and laws that are enforced by relevant medical or professional bodies, including but not limited to, the General Medical Council, Nursing and Midwifery Council, Health and Care Professions Council and others. Such breaches may result in legal action and could potentially affect a practitioner’s standing and licensure with their respective regulatory body. Therefore, it is of utmost importance for Licensees to uphold the highest standards of patient confidentiality.
This action may include, but is not limited to:
- Issuing a formal warning to the Licensee.
- Temporarily suspending the Licensee’s rights and privileges under this Agreement.
- Permanently revoking the Licensee’s rights and privileges under this Agreement.
- The specific action taken will depend on the severity and frequency of the violation. The Programme also reserves the right to seek any legal remedies available under applicable law.
- Licensees have the right to appeal any action taken against them. Appeals should be submitted in writing following the Sourdough School complaints procedures within 7 days from the date of the action.
12.0 Termination
This Agreement can be terminated with immediate effect if the Licensee fails to comply with any of the terms of this agreement, fails to maintain adequate professional liability insurance, or is found to be acting unethically or against the interests of the Patients or the Programme. Upon termination, the Licensee must immediately cease all activities related to the Programme, including the prescription of Sourdough Club memberships.
12.1 Either party may terminate this agreement with a 30-day notice. The Licensee may cease their activities related to the Programme after the notice period. After termination, no new prescriptions for Sourdough Club membership can be issued. However, previously issued prescriptions remain valid unless the patient chooses to leave the Programme.
12.2 The Programme reserves the right to change the terms of this agreement from time to time. Any changes will be communicated to the Licensee, and continued activity after the changes implies acceptance of the new terms. If the Licensee does not agree with the changes, they have the right to terminate the agreement within 30 days of the notice of change.
13.0 The Agreement
13.1 This Agreement supersedes and replaces all prior agreements, understandings, and arrangements, whether oral or written, relating to its subject matter. This Agreement may be executed in any number of counterparts, each of which when executed and delivered shall constitute an original of this Agreement, but all the counterparts shall together constitute the same Agreement.
13.2 The Agreement shall be governed by and construed in accordance with English law, and each party irrevocably agrees to submit to the exclusive jurisdiction of the courts of England over any claim or matter arising under or in connection with this Agreement or the legal relationships established by this Agreement.
