What is Social Prescribing in Health and Social Care?

Nell Hendy

June 21, 2021

5 min read

Health conditions have a significant impact on nearly every aspect of people’s lives. This includes mild or long-term health problems, complex needs, social isolation, mental health issues and a multitude more. Health conditions affect people and their lives in very different ways, therefore addressing the impact will be different for each person and should be done in a holistic way.

Social prescribing recognises the impact of social, economic and environmental factors on people’s health and wellbeing. Social prescribing networks aim to support people’s needs in a person-centred way, whilst encouraging patients to take control of their own health.

This article will explain what social prescribing is, including the role of a link worker, why it is important and how professionals can promote it.

Social prescribing allows healthcare professionals such as GPs, nurses and care assistants to refer individuals with health conditions to non-clinical services or activities. These services are local and often provided by voluntary or community sector organisations. Examples of social prescribing activities include gardening, cookery classes, sports, arts and group learning.

The activities provide a person-centred approach to helping patients with practical, social or emotional needs. Rather than turning to medical treatment, social prescribing allows exploration of non-clinical treatments specific to each individual patient’s needs. It also allows patients to take greater control over their health and has been referred to as a ‘more than medicine’ approach due to the evidence that some long-term health conditions can be prevented by lifestyle change.

Social prescribing is suitable for anyone with one or more long-term health conditions, people who need mental health support, people who are lonely or isolated and individuals with complex social needs.

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There are different models of social prescribing emerging throughout the country, with more predicted to evolve over the next few years, due to the subjective nature of social prescribing. Services and activities are tailored to local needs and resources in specific communities and therefore they are specific to each patient population’s needs. A standard model of social prescribing has been developed to show the key elements that should be in place for effective social prescribing. It includes:

Easy referral from local agencies
Workforce development
Common outcomes framework
Personalised plans
Support for community groups
Collaborative commissioning and partnership working

Referrals for social prescribing come from a multitude of different people and are sometimes known as community referrals. They can come from:

GPs
Pharmacists
Health care assistants
Social care services
Police
Hospital discharge teams
Local agencies
Multi-disciplinary teams

Many different professionals are involved in social prescribing and self-referral is also actively encouraged. After referral, the patient will be allocated a link worker to design a package of services or activities to meet their needs and connect them to those services in the local community.

What is the Role of a Link Worker?

If a patient has been referred to the community, they will be allocated a link worker to collaborate with. Through shared decision making and personalised care and support plans, link workers spend time focusing on what matters to the patient and identifying what could help improve their health and wellbeing.

Link workers then refer patients to community support or services that patients are interested in and will help with their health condition. These local services provide practical and emotional support, as well as engage and deal with some of their underlying causes of ill health such as poor nutrition, lack of physical activity or lack of emotional support.

Link workers also collaborate with local partners to support community groups ensuring they are accessible and sustainable. Identifying space for new potential activities or community groups and helping to set them up also involves link workers.

Emerging evidence demonstrates the positive health and wellbeing outcomes for patients that have accessed the community through social prescribing such as; improved quality of life, positive emotional wellbeing and promotion of self-care. Additionally, the feeling of belonging due to participating in a community group and having peer support, has been found to reduce anxiety and loneliness.

Social prescribing can help patients find a new purpose whilst enjoying activities they may have never tried before. Being connected to community groups through social prescribing enables people to be more physically active and improves mental health, helping them to stay well for longer and lessen the impact of long-term health conditions.

Social prescribing networks are also important for health and social care as they are aimed at patients who regularly attend primary or secondary healthcare services. Engaging patients with communities can lead to prevention and early intervention of health conditions, therefore reducing the demand on primary health services.

Social prescribing is part of a long-term plan committed to personalised care across the health and social care system. By the end of this year over 1,000 link workers are estimated to be trained, with this figure rising over the next few years. By 2023/24, referrals through social prescribing schemes are estimated to surpass 900,000.

Social prescribing services include a multitude of activities and projects based in the community, specific to local patient needs and resources.

Activities include:

Cookery classes
Arts and crafts
Gardening
Group learning
Sports groups
Singing groups

Below are examples of how social prescribing might be used to support people with different health conditions:

Social anxiety – Your social anxiety makes it hard for you to make new friends or even open up to people you already know. Your therapist taught you techniques to help manage your fear and nerves when in a social situation.

Jumping into direct socialisation to practice these techniques is too overwhelming, but there are not many alternative situations you can think of.

Your link worker asks about your hobbies and interests, and you say that you like to bake as it helps you relax. With help from your link worker, you decide to attend a local bakery club.

Knowing the other people at the bakery club share an interest with you gives you a good starting point to create or engage in conversation and spend time in a social situation.

Diabetes – You have type 2 Diabetes and you and your doctor agree there needs to be a change in your diet to help with managing your condition. You want to learn more about healthy eating and nutrition but all the information you find is linked to expensive diet plans or weight loss groups.

Your doctor gave you a leaflet containing some healthy recipe ideas, but you have not cooked from scratch before so you do not know where to start.

You are put in contact with a link worker to explore the local support available. Your link worker suggests a cookery class for beginners – the class teaches about nutrition and a balanced diet. The class also gives you a chance to practice making meals with other beginners that do not have much experience of cooking either.

There is limited systematic evidence demonstrating the success of social prescribing as it is specific to each different populations’ needs. Therefore, no two local communities have the same social prescribing networks, making researching and measuring the overall success very difficult. However, there are numerous success stories and emerging evidence displaying the effectiveness of social prescribing networks in terms of improving emotional wellbeing, mental health and increased physical activity.

The clinical lead for social prescribing at Merton and Wandsworth, Dr Mohan Sekeram, has witnessed first-hand the successes of social prescribing and the impact it has had on people:

One patient visited me because she was struggling with stress, depression and anxiety, so was partnered a link worker. She says the encouragement and support she received stopped her from feeling so isolated.

Another patient was being treated for depression with antidepressants, and signed off work as sick. He was referred to a link worker who identified a role as a chef in the local community centre. This improved his self-esteem and he was able to return to work and stop taking medication.”

Dr Mohan Sekeram

Social prescribing improves outcomes for both patients and health services. By promoting the use of local activities and services, social prescribing can reduce the pressure on healthcare. Directing people to the community gives patients more choice, control and input with their care, whilst reducing attendance on primary and secondary health services.

Communication and relationships between professionals in health-care and local communities or link workers will increase the overall success of social prescribing. When working with a patient in a health-care setting, considering the way in which social and emotional needs are affecting their health can promote social prescribing.

For example, if a patient does not have a support network or any close relationships for emotional support, local services or groups could help, as opposed to suggesting a medical treatment.

In order for social prescribing to work effectively link workers, health-care professionals and local services must have access to the most up-to-date information. Therefore, building relationships and establishing communication between social prescribing services and local communities is imperative.

Social prescribing provides a person-centred approach to care, referring patients with health conditions to link workers and then connecting them to local communities and activities, as opposed to primary or secondary health services. Social prescribing networks value the individual and create personalised plans to improve their emotional wellbeing and physical health. Health-care professionals should promote the use of social prescribing in order to reduce the demand on health services.

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What is Social Prescribing in Health and Social Care?