What is social prescribing? A South Eastern NSW case study (1/3)
In 2020, COORDINARE engaged health and social services consultancy Beacon Strategies in partnership with facilitators Carrie Lumby from Troubled Dog and Dr Belinda Thewes to lead a co-design process to develop a model of social prescribing tailored for the South Eastern NSW region.
The program model to be designed was aimed at building social connection and self-management capacity in people living with or at risk of chronic conditions in South Eastern NSW.
With the continued focus on social prescribing as a ‘high-value, low-cost’ way of improving the responsiveness of the health system, we thought it would be worthwhile to unpack some of what we learnt in that project to share with other PHNs commissioning social prescribing service models or linkage program providers. This blog is the first of three in a South Eastern NSW case study series: what is social prescribing?
What is social prescribing?
“Social prescribing, also sometimes known as community referral, is a means of enabling health professionals to refer people to a range of local, non-clinical services. The referrals generally, but not exclusively, come from professionals working in primary care settings, for example, GPs or practice nurses.” (1)
The concept and practice of social prescribing is increasingly gaining momentum in the health planning and policy landscape.
There is widespread recognition of the association between ‘social’ factors and health and quality-of-life outcomes. This is seen in both a causative sense — the traditional ‘social determinants of health — where social factors can act to promote or inhibit good health. But a deeper understanding of the experience of people living with health conditions, and the impact this can have on someone’s social and emotional wellbeing and ability to fully participate in their communities.
There is also a gradual acceptance that the prevailing health system model is overly medicalised, diagnosis-focused and often unable to meet the holistic needs and preferences of people to drive positive health outcomes.
Social prescribing in South Eastern NSW
In our co-design process in South Eastern NSW, we heard people describe the importance of social prescribing to them as:
meeting universal human needs — joy, meaning purpose, hope and connection
offering a holistic response focused on both physical and mental wellbeing
addressing loneliness
recognising the connection between wellbeing and creativity
maintaining a person’s identity beyond just being a patient
addressing the stigma attached to chronic conditions
building motivation for treatment and self-management
better targeting and utilising health system resources.
Social prescribing is not a program, a service or an activity in itself. The definition above is intentionally broad, and is defined more by way of principles that underpin a social prescribing model, and the outcomes that it strives to shift.
At its core, social prescribing provides a way of connecting patients with non-medicalised sources of strength, support and healing that enable good health.
“People have to be able to laugh, move and learn things… these are universal human needs”
“Non-clinical interventions give people a chance to step outside the box of being a collection of their symptoms”
While social prescribing is generally still seen as an emerging concept, there are a range of ways in how the concept can be implemented within a health system — our team uses the language of a ‘model’ to reflect that this can be applied in different ways to meet local needs or context.
Examples
The Bromley by Bow Centre in East London is one example of social prescribing that creates integration of health and community supports in ‘place’. Bromley by Bow challenges the idea that social prescribing is a relatively new concept and has been built by and with the local community over a few decades. This short video helps to explain the Bromley by Bow Centre’s approach.
Another instructive example is Scotland’s Links Worker Programme where a dedicated, non-clinical member of staff (a Community Links Practitioner) is located directly within general practice settings. These link workers are responsible for ‘providing the missing link to the provision of specialist non-clinical support for the management of long-term conditions that has been missing in traditional primary health care settings’.
Now that we’ve identified what social prescribing is, let’s move onto part 2 of this blog series, what ‘good’ social prescribing looks like.
Sources:
Buck D., Ewbank L. (2020). What is social prescribing? The King’s Fund: UK. Available at: https://www.kingsfund.org.uk/publications/social-prescribing
Looking for more help to designing programs and services for impact? Check out how we can help here. Or, keep reading about the work we do with Primary Health Networks.