Social Prescribing

Introduction

Social prescribing has the potential to connect communities and healthcare. It involves linking patients to community-based support as a way of supporting people’s health and wellbeing. Social prescribing tends to focus on wellness instead of illness. Here we share what we’ve learned from community groups who have piloted or scaled social prescribing, or who provide services as part of existing schemes.

Why this matters

Experiences like social isolation, stress, and discrimination play a contributing role in many physical and mental health conditions. As do lifestyle factors like diet and exercise, smoking, drinking or drug use.

Social prescribing can’t resolve underlying inequalities. But, its advocates say it’s a holistic and personalised way to address symptoms through non-medical support that complements conventional health treatments like medication.

This can mean offering anything from physical and social activities, like walking groups, dance classes, healthy eating lessons and mindfulness courses, to peer support or advice on debt. Social prescribing is often described as a way to support people’s quality of life. There is a lack of systematic evidence about its effectiveness, but there are individual examples linking social prescribing with positive impacts. These include a reduction in the use of NHS services, and improvements in anxiety and feelings about quality of life.

The lessons captured here are meant to inform discussions about the design and implementation of future social prescribing schemes.

What we've learned

There are 3 key ingredients in most social prescribing models

There are many different models for social prescribing, but we’ve seen that most have 3 key elements.

Referral

Typically a General Practitioner (GP), nurse, pharmacist, social worker, or a charity or community outreach worker refers the patient to a link worker. The referral recognises that someone would benefit from a different kind of intervention in addition to, or instead of, medical treatment.

Prescription

 Working with the patient, the link worker identifies activities that can improve their health, wellbeing or personal situation. There is a genuine partnership between the individual and the link worker: building rapport, exploring interests and barriers, and connecting patients with services that build on their potential.

Activities

The individual takes part in prescribed services, mostly provided by the local voluntary sector. These vary from one-off activities and individual support to group classes and open ended specialist support services.

It's important to build a network of good referral partners

A steady flow of appropriate referrals to social prescribing schemes is vital.

Our grant holders have found that referrals work best when they come from a range of sources rather than relying solely on GP surgeries. Building strong local networks, being visible in the community, and investing time in relationship building are key to achieving this.

Keeping the referral process as simple and accessible as possible can improve uptake. This may involve co-locating services with GP practices or voluntary sector organisations, integrating with healthcare IT systems where appropriate, and removing unnecessary bureaucracy such as lengthy forms.

Checking in regularly with partners, sharing successes, and giving regular feedback about the impact of social prescribing services on individuals helps build trust and momentum.

Being explicit about what the social prescribing scheme can and can't offer helps to manage expectations, reduce inappropriate referrals, improve partnership working, and build trust among both referrers and patients.

Looking after link workers

The link worker role is essential, requiring a range of skills, experience and local knowledge.

It’s important to ensure the pay of link workers reflects the skills and experience needed - the role is challenging as they must be effective at a one to one level with patients and able to operate at a strategical level with partners.

Link workers need up-to-date knowledge of what’s on offer from the local voluntary sector – and an understanding of the challenges faced by people in the area makes it easier to navigate the barriers to support.

Good link workers come from a range of backgrounds, but listening, patience and empathy are often described as key qualities.

Providing opportunities for link workers to reflect on their work and share experiences with one another is important for supporting their wellbeing.

Creating person-centred approaches

How link workers work with people can be as important as the activities they refer them to.

We’ve seen that the rapport and quality of the relationship between individuals and their link worker can be central to good social prescribing practice. Being welcoming and warm, listening and taking an interest in the person and their situation is an important first step.

The link worker can often act as a motivational coach, encouraging people to take small steps to overcome issues. Working together to co-create options that support independence, not dependence, is important.

There is no formula for the kind of activities that social prescribing schemes should use – it’s much more about finding the right fit for each individual, something that motivates and empowers them.

Making social prescribing work for everyone

There are key learnings to make social prescribing work for both the healthcare and voluntary sectors.

Funding

It’s necessary to pay for the whole service, not just parts of the process. There have been challenges in ensuring that the services and activities offered by community groups are adequately and sustainably funded.

Credibility building

Showing what’s possible with social prescribing, and being intentional about adding to the evidence base, can gain credibility and buy-in.

Collaboration and relationships

Building trust and understanding between the healthcare and voluntary sector organisations helps. Funding shouldn’t create perverse incentives or competition.

Key messages

Social prescribing has the potential to benefit individuals, the voluntary sector and the health system by making better use of resources and giving people greater control of their own wellbeing.

Charities and community groups play a vital role in social prescribing by running many of the prescribed activities and providing the link worker function.

Social prescribing offers opportunities for the sector in terms of reaching new people and promoting a holistic way of working, but it also presents a challenge for funding and resourcing. Therefore, for social prescribing to flourish we must support both the link worker role and the delivery of end services in the voluntary sector.

There is a need for better evidence to show the strength and impact of the approach. We can support social prescribing to realise its potential by making social interventions more visible, finding ways to show their impact, and assuring the quality of the end service.

Find out more

We carried out this research in 2019. Find the full report in our Evidence Library.

You can search our Evidence Library for other National Lottery funded studies on social prescribing.