Can social prescribing provide the missing link?

Abstract

Background: The voluntary sector has long been recognised as making an important contribution to individual and community health. In the UK, however, the links between primary health care services and the voluntary and community sector are often underdeveloped. Social prescribing is an innovative approach, which aims to promote the use of the voluntary sector within primary health care. Social prescribing involves the creation of referral pathways that allow primary health care patients with non-clinical needs to be directed to local voluntary services and community groups. Such schemes typically use community development workers with local knowledge who are linked to primary health care settings. Social prescribing therefore has the potential to assist individual patients presenting with social needs to access health resources and social support outside of the National Health Service. Aim: The aim of this paper is to explore the concept of social prescribing and discuss its value as a public health initiative embedded within general practice. Methods: The rationale for social prescribing and existing evidence are briefly reviewed. The paper draws on a case study of a pilot social prescribing scheme based in general practice. Data collected during the development, implementation and evaluation of the scheme are used to illustrate the opportunities and limitations for development in UK primary health care. Findings: The potential for social prescribing to provide a mediating mechanism between different sectors and address social need is discussed. The paper argues that social prescribing can successfully extend the boundaries of traditional general practice through bridging the gap between primary health care and the voluntary sector. The potential for wider health gain is critically examined. The paper concludes that social prescribing not only provides a means to alternative support but also acts as a mechanism to strengthen community-professional partnerships. More research is needed on the benefits to patients and professionals.

Social prescribing in general practice: adding meaning to medicine

“…7 Other research has also reported difficulty with recruitment to social prescribing schemes. 5,11 This is despite the markers for suitability (listed previously) being very common.…”

“…The most favoured among existing schemes involves the use of a 'facilitator' (or referral agent or navigator) coupled with personal support (often a volunteer) for the patient in actually taking up social opportunities. [3][4][5] The facilitator is employed to act as a bridge between primary care professionals and the panoply of social opportunities. It is a challenging role requiring good listening skills and the ability to relate in an inspiring way to health professionals, the wide variety of people in the third sector and, of course, the patient who has been referred.…”

“…For instance, it is likely that simply meeting an inspiring facilitator can be beneficial even before any other social contact. 5 The NHS could benefit from frequentattending and high resource-consuming patients 'moving on' when the demonstrable benefit they gain from the NHS is minimal or negative. However, research into the Expert Patient Programme (EPP) showed that in the short-term these patients did not consult less although they did have improved quality-of-life measures, increased energy and self-efficacy.…”

“…Similar patterns have been identified elsewhere. 4,5 In EPP research, people with unsatisfactory relationships with health professionals were more likely to change their behaviour with EPP intervention. 12 Generally, EPP benefited those wishing to be more selfefficacious and take responsibility for their own health.…”

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

“…Consequently, voluntary organisations and charities as third sector organisations are increasing their role in providing an adjunct to primary care services (Coid, Williams, & Crombie, 2003;Secretary of State for Health, 2006). Social prescribing, also referred to as community referral, has gained considerable attention in recent years (Husk et al, 2016;Kilgarriff-Foster & O'Cathain, 2015;Mossabir, Morris, Kennedy, Blickem, & Rogers, 2015;South, Higgins, Woodall & White, 2008). Social prescribing is defined as: "A mechanism…”