Social prescribing: a review of community referral schemes

Better known models of social prescribing include: ‘Arts on Prescription’; ‘Books on Prescription’; ‘Education on Prescription’; ‘Exercise on Prescription’ and ‘Volunteering’.

Lesser known community referral models include ‘Green Gyms’ (activities and exercise in a natural environment) and other ‘Healthy Living Initiatives’; ‘Computerised Cognitive Behavioural Therapy’ (online self-help reading often facilitated); ‘Supported Referral’ (any scheme supported by a facilitator); ‘Social Enterprise Schemes’ (disadvantaged people employed in the workplace); ‘Supported Employment’ (an advisor supporting employee in work); ‘Time banks’ (volunteered time used as currency); and ‘Information Prescriptions’ (‘signposting’ to available services within communities often via websites).

The term ‘prescribing’ potentially connects us up with a medical model of care; there are plusses and minuses to this link which need to be considered. An alternative term might be ‘referral’ which broadens the process to people outside of medics.

There are several components of social prescribing. These include the programme or activity itself (e.g. group singing for people with dementia); what the scheme hopes to achieve (health, wellbeing and/ or social outcomes need to be stipulated ); how the scheme fits in with a care pathway, local health and social priorities and public health and/or health care policy objectives.

Rationale: Social prescribing in the UK has been brought about by decentralisation of  healthcare decision making from national to local government, an emphasis on the notion that prevention is sometimes more attainable than cure, and the organisation of multi-agency and more holistic approaches to healthcare.