Social Prescribing in National Health Service Primary Care: What Are the Ethical Considerations?

Early View Perspective

Policy Points:

  • Social prescribing is proposed as a way of improving patients’ health and well-being by attending to their non-clinical needs. This is done by connecting patients with community assets (typically voluntary or charitable organizations) that provide social and personal support.
  • In the United Kingdom, social prescribing is used to improve patient well-being and reduce use of National Health Service resources.
  • Although social prescribing schemes hold promise, evidence of their effects and effectiveness is sparse.
  • As more information on social prescribing is gathered, it will be important to consider the associated ethical issues for patients, clinicians, link workers, and community assets.

Social prescribing is an effort to recognize and address the broader, nonclinical contributors to health and well-being made by social and economic factors, while maintaining the clinical role of medically trained staff. It offers support to patients who have unmet social and personal needs (e.g., loneliness, debt, insecure housing, and bereavement) that can adversely impact on their health1 by directing them toward locally available nonclinical services such as support groups and activity schemes. Social prescribing may facilitate greater patient activation, including improved self-management of long-term conditions, by building connections and networks around individuals, meaning they are less dependent on health professionals for support.2

In the United Kingdom, social prescribing has become a part of mainstream National Health Service (NHS) service provision. The NHS Long Term Plan pledged to recruit 1,000 link workers by 2020/2021 as part of newly formed primary care networks,3 and since the COVID-19 pandemic began, additional funds have been made available to support this recruitment drive.4 The NHS employs link workers to meet with patients for an extended time period, discuss their needs, help them set goals and develop an action plan, and direct them toward available services (typically voluntary and community organizations). Patients are referred to link workers via general practitioners (GPs) and other members of their primary care team, including nurses, midwives, and receptionists. It is also possible for people to self-refer for some services.

Open Access

Citation:
Brown RCH, Mahtani K, Turk A, Tierney S. Social Prescribing in National Health Service Primary Care: What are the Ethical Considerations? Milbank Q. June 25, 2021. https://doi.org/10.1111/1468-0009.12516