Impact 101: What is social prescribing?
Bewildered by buzzwords? Drowning in jargon? Pioneers Post journalists and experts break down the terminology and get back to basics on impact economy concepts. Ingrid Abreu Scherer from the National Academy for Social Prescribing provides your Impact 101 on ‘social prescribing’ – and highlights the opportunities for social enterprises.
What is social prescribing?
Ingrid Abreu Scherer: Up to one in five patients in the UK go to their general practitioner [family doctor] for issues that are not exclusively or even mainly addressed by medical treatment; researchers have also found that around 80-90% of health outcomes are influenced by social factors.
Social prescribing is a way to connect some of these people to practical and emotional support in their communities and beyond. Sometimes this is done via “link workers” – professionals who work with people to find out what matters to them personally, then connect them to community-based activities (and during Covid-19 to remote and digital services) that support their health and wellbeing. Potential funders of these in the UK include the NHS, local authorities, charitable trusts and foundations.
Social prescribing helps people get more control over their healthcare, to manage their needs and in a way that works for them. It can especially help people who:
- have one or more long-term conditions
- need support with their mental health
- are lonely or isolated
- have complex social needs which affect their wellbeing.
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When did social prescribing first emerge, and in what parts of the world is it being used?
IAS: Social prescribing has existed in many forms across the world, but has been building momentum over the past decade.
Social prescribing as it is now understood first developed in the UK in the 1990s, when GPs at the Bromley by Bow Health Partnership (which is a health focused social enterprise) launched a scheme to refer patients to in-house expert non-clinical services.
As of 2021, there are social prescribing initiatives in at least 17 countries
As of 2021, there are social prescribing initiatives in at least 17 countries. Specific components and implementation approaches vary across settings, depending on country and community contexts.
In early 2021 the Global Social Prescribing Alliance published the Global Social Prescribing Playbook, showcasing best practice from around the world, and how social prescribing can support the UN’s Sustainable Development Goal 3, to ensure health and wellbeing for all, at every stage of life. Across countries, job titles for new social prescribing roles have been tailored to resonate with the local culture and population: “link worker team” in China, “wellbeing coordinator” in Singapore, “community connector” in Wales and “wellbeing coach” in the Netherlands. There are different names for it around the world, but what is transferrable is that people are being connected to their community and resources to address the social determinants of health.
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How big is the social prescribing 'market'?
IAS: This isn’t an easy thing to answer, even within the UK, since health budgets are used very differently across the country. However, the NHS has committed to expanding ‘personalised care’, and social prescribing is a major aspect of that.
In 2021 social prescribing referrals saw a fourfold increase over the previous year to around 500,000, though there are still significant barriers to uptake. (For example, people living in deprived communities were more likely to be referred through social prescribing, but less likely to take up the referral.)
One of the key strategic shifts in the NHS Long Term Plan is a commitment to growing social prescribing, so by 2023/24 every GP practice in England will have access to a social prescribing link worker, supporting a total of 900,000 people.
Which kind of organisations is social prescribing most relevant to – and how can social enterprises get involved?
IAS: Organisations that can support health and wellbeing are especially suited. These can be through activities that connect people to each other in meaningful ways, volunteering, arts and culture, physical activity and accessing green spaces. Organisations that support people’s learning, employment, housing and other essential needs are also very important, as are those that provide expert advice and support for specific health conditions. Any UK organisation can get started by joining one of the ‘Communities of Practice’ set up by the National Academy for Social Prescribing.
Many social enterprises will already be offering activities and support that fit the social prescribing model
Many social enterprises will already be offering activities and support that fit the social prescribing model. Whether you’re a housing association, community theatre, or volunteer-run social club – your activities can help support health and wellbeing.
There are still many people who are not benefitting from social prescribing for a number of reasons – there are waiting lists to see link workers, their local area doesn’t have enough activities, or the offer isn’t suitable for them. Social enterprises could help address health inequalities by offering support to excluded groups.
What challenges should newcomers consider when delivering social prescribing work?
IAS: A survey of the first 50 national organisations to join our Accelerating Innovation community of practice found 74% were held back by lack of funding; 68% by shortage of time and resources and 42% by not having delivery partners for their proposed service.
Securing funding is one of the biggest hurdles we hear. It’s important to draw up a budget that reflects all the costs involved, including additional capacity needed to support vulnerable people.
However, it doesn’t always come down to new money. It’s important for organisations to work in partnership with others in a place to make the most of complementary skills and resources. Many organisations have been connecting people to their community for years to support their health and wellbeing – but more formal support can help build that infrastructure.
It’s also very important to be able to show that the activities you provide work – and that they make a difference to the metrics that funders and commissioners are looking to change. These include reduced loneliness, increased wellbeing and confidence in managing conditions, as well as savings to the health system in reduced GP visits.
How is it likely to evolve in future? What factors will affect whether it grows or not?
IAS: The evidence for social prescribing is growing steadily, and NASP’s Academic Partnership works to bring together research in a robust and useful way. We need to continue to grow the evidence of what works by using common measures in evaluations.
We’ve learned a lot from ideas tried during the Covid-19 pandemic that are likely to grow in the future. For example, digital activities or remote support, connecting people through technology, helping neighbours look out for each other, and the importance of local green space when people are stuck indoors.
The NHS is committed to a personalised and place-based model of care, and social prescribing fits into that vision. However, social prescribing is only as strong as the strength of civil society – and the charities and social enterprises that provide activities and support.
- Ingrid Abreu Scherer is head of accelerating innovation at the National Academy for Social Prescribing.
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