Implementing Social Prescribing Referrals into General Practice and Care Navigation

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A practical look at the benefits of social prescribing.

Social Prescribing is fairly established in General Practice, but ensuring that everyone within the multidisciplinary team is aware of this role, can have its challenges.

Around 20% of patients consult their GPs for problems that are primarily, social, rather than medical and dealing with these needs is important, because both social and economic factors affect health outcomes.

Any patient can be referred to Social Prescribing if it represents the most appropriate tool for addressing their needs. This is often in the form of social or emotional assistance. Patients accessing Social Prescribing services will typically be those with mental health needs, multiple long-term conditions, suffering from isolation or loneliness, or having complex social needs.

Introducing Social Prescribing into the Care Navigation pathway effectively can have a significant impact on alleviating the pressures on GPs. So, evaluating the skills of the whole team can help surgeries to improve the running and efficiency of the practice, ensuring that patients receive the right care the first time and as effectively and efficiently as possible.

Social Prescribing is so broad, that it’s important that both clinical and non-clinical staff fully understand the role. This is imperative, to maximise the effectiveness and sustainability of the role. It can take time to educate the wider team on the value of Social Prescribing, it can also be challenging to define who would benefit.

How to implement Social Prescribing referrals.

Provide all staff with clear guidance and protocols, such as -

  1. Explanation of the service
  2. Criteria of eligibility
  3. Referral pathways

Explanation of service (example)

Social Prescribing is a non-clinical signposting service linking people into services, groups, and organisations for practical and/or emotional support.

Social Prescribing explores what matters to the patient, Social Prescribers create a plan together with the patient which empowers them to take control over their situation, while helping them to link into services to enable positive life changes.

The personalised support can be delivered over many appointments, giving the patient time and confidence to work on the underlying issues which are affecting their overall health and wellbeing

Criteria (example)
Referral pathways

  • 18 +
  • Housing, debt and benefits issues, including housing support/advice, struggling with forms, in debt, benefits help/advice
  • Utility & financial difficulties
  • Bereaved & struggling to cope
  • Loneliness and isolation, including social needs and interaction, lacking direction in life/low confidence/low self-esteem & social anxiety
  • Mental Health – Depression, anxiety, stress & low mood (to give direction and purpose in life)
  • Practical Help, for example, linking to services to help with practical problems, cleaning, mobility, supporting aids
  • Long-term health conditions including Chronic pain, Diabetes, COPD, Dementia, Sleep, Mobility etc
  • Low-level addiction & recovery (getting focused)
  • Learning, voluntary & employment opportunities, for example having lost job, redundancy, finding a job, volunteering, new career, learning something new
  • Mental, physical & learning disability opportunities
  • Struggling with parenthood & caring
  • Lifestyle support and weight management (losing weight, exercising/moving more, Live Well)
  • Finding a club, activity, group, or peer support they are interested in
  • Long Covid (signposting to self-support/management options/groups)

Proving clear, seamless, easy referral pathways, and making sure everyone is familiar with how to refer.

Applying these simple guiding principles ensures effective knowledge and use of the service.

To reinforce that Social Prescribing is understood and ensure there is effective communication between patients and staff, it is recommended that Social Prescribers regularly attend GP, Nurse, Reception, and Care Navigation staff meetings. The Social Prescribers would give examples of referrals, telling the patient stories and successes. This can be a very powerful way to join the dots. I advocate spending time training Reception and Care Navigation staff on the benefits of Social Prescribing to enable them to fully understand the role and ask questions. This would enable them to upskill and provide better care and understanding of the patient’s needs, therefore increasing the opportunities for patients with long-term conditions (LTCs) to access non-clinical support options via primary care.

Team productivity is all about helping the team work together to get things done while making the best use of their unique combination of strengths. A team that works well together, effectively, and productively, offers benefits for each team member.

At its best, Social Prescribing has the potential to relieve pressures on GPs and Primary care services by offering an alternative pathway to patients whose needs are unable to be addressed through the usual medical routes.

By Hannah Cayless, Lead Social Prescriber for the Paignton and Brixham Primary Care Network.

Social Prescribing has the potential to relieve pressures on GPs and Primary care services by offering an alternative pathway to patients whose needs are unable to be addressed through the usual medical routes.