Social Prescribing and Primary Care: A Call for Papers that Push the Envelope for Equitable, Sustainable and Impactful Social Prescribing
Published in Healthcare & Nursing and Social Sciences
In 2019, NHS England in the UK invested in 1,000 “link workers” to help primary care patients with their non-clinical needs (e.g., social isolation; financial, housing, and food insecurity) by connecting them with community resources and support networks, empowering patients to take more control over their own well-being (NHS England 2019). This marked a significant shift in progressing social prescribing, which has a long history in the UK as a means of addressing social determinants of health, beginning in the 1980s (Morse et al. 2022). The past five years have seen significant international growth in the practice of social prescribing, which has spread to over 30 countries around the world (National Academy for Social Prescribing 2024).
Decades of research, and millenia of human experience, demonstrate the importance of action on the social determinants of health, from building social connection and engaging in physical activity to access to housing, arts, and time in nature (WHO Commission on Social Determinants of Health and World Health Organization, 2008). But in many industrialized countries, health systems remain mired in 19th and 20th century understandings of health, despite clear indications of the limitations of over-investment in acute biomedical care (Blumenthal et al. 2024). Social prescribing offers the potential to shift the scale through investment in community resources and establishment of referral pathways to address social determinants of health.
Social prescribing in primary care can take various forms, including the provision of link workers who build relationships with individuals and connect them to resources, and community development approaches that focus on building community capacity. The most effective social prescribing approaches incorporate both through place-based co-design, in which individuals and communities actively participate in developing programs that meet their specific needs and priorities (Muhl et al. 2024).
The evidence to date is promising: better health experiences and outcomes, and returns on investment of up to $4.43 (CAD) in reduced healthcare costs and improved economic and social participation (Candian Institute for Social Prescribing 2024).
We still have a lot to learn about social prescribing, with systematic reviews calling for high quality research to better understand the evidence base for social prescribing (O’Sullivan et al. 2024). There are also important lessons for social prescribing from across the Global South and in some parts of the Global North, where community health workers provide high-impact, low-cost health services by focusing on health promotion and prevention through trusted, locally embedded relationships with community members (Van Iseghem et al. 2023). In Australia, for example, Aboriginal and Torres Strait Islander Community Controlled Health Organizations have been connecting people to services to address socio-economic and cultural determinants of health since the 1970s (Yadav et al. 2024). In Canada, Indigenous-led health care and partnerships are a core component of national approaches to Truth and Reconciliation; “Indigenous-led movements that centre on traditional Indigenous knowledge have become an important feature of the Canadian medical landscape, promoting cultural activities, self-determination, governance, language, medicine and wellness" (Allen et al. 2020).
Challenges to the progress of social prescribing include the lack of a shared theoretical framework, the potential for overburdening existing community services and resources, the risk of individualizing social needs instead of addressing systemic issues, the need for better evaluation capacity in community services, and the potential to exacerbate inequities in access and delivery for populations already facing barriers to care. Furthermore, adequate funding and sustainable structures are crucial for the long-term success of community-based social prescribing programs. As social prescribing “comes of age,” practitioners, researchers and communities must engage critically with these strengths and shortcomings. For these reasons, we are seeking papers for this special issue of BMC Primary Care that push the envelope on more equitable, sustainable and impactful social prescribing.
References
Allen, L., Hatala, A., Ijaz, S., Courchene, E. D., & Bushie, E. B. (2020). Indigenous-led health care partnerships in Canada. Cmaj, 192(9), E208-E216.
Blumenthal, D., Gumas, E., & Shah, A. (2024). Mirror, mirror 2024: a portrait of the failing US health system. The Commonwealth Fund. https://www.commonwealthfund.org/publications/fund-reports/2024/sep/mirror-mirror-2024#:~:text=Introduction,health%20systems%20in%20selected%20countries
Canadian Institute for Social Prescribing (2024). A Healthier Canada: An Analysis of the Potential Economic and Social Impacts of Social Prescribing. https://www.socialprescribing.ca/a-healthier-canada
National Academy for Social Prescribing (2024). Social Prescribing Around the World. https://socialprescribingacademy.org.uk/resources/social-prescribing-around-the-world/
NHS England (2019). Social Prescribing. https://www.england.nhs.uk/personalisedcare/social-prescribing/
O’Sullivan, D.J., Bearne, L.M., Harrington, J.M., Cardoso, J.R., & McVeigh, J.G. (2024). The effectiveness of social prescribing in the management of long-term conditions in community-based adults: A systematic review and meta-analysis. Clinical Rehabilitation, 38(10),1306-1320.
Van Iseghem, T., Jacobs, I., Vanden Bossche, D., Delobelle, P., Willems, S., Masquillier, C., & Decat, P. (2023). The role of community health workers in primary healthcare in the WHO-EU region: a scoping review. International Journal for Equity in Health, 22(1), 134.
WHO Commission on Social Determinants of Health, & World Health Organization. (2008). Closing the gap in a generation: health equity through action on the social determinants of health: Commission on Social Determinants of Health final report. World Health Organization.
Yadav, U.N., Wyber, R., Cornforth Wuthathi/Maluilgal, F., Lovett Wongaibon/Ngiyampaa, RW. (2024). "Social prescribing" another stolen Indigenous concept? Medical Journal of Australia,221(6), 346.
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BMC Primary Care
Previously known as BMC Family Practice, this is an open access, peer-reviewed journal that considers articles on all aspects of primary health care research.
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