Joining Canadian colleagues to share learning about social prescribing

In late September 2024, myself and colleague Debra Westlake were lucky enough to attend Canada's Social Prescribing Conference in Toronto. This two-day event provided us with a fantastic opportunity to hear about how social prescribing was being delivered across this country; we met lots of individuals involved in social prescribing, many of whom were from the voluntary-community sector or not-for-profit. We were impressed by the growth of social prescribing within Canada, in only a couple of years, supported by the Canadian Institute of Social Prescribing (CISP) in collaboration with the Canadian Red Cross. This was reflected in the size of the conference, attended by approximately 450 people.

The event started by acknowledging indigenous wisdom on holistic wellbeing through a plenary from Elder Dr. Albert Marshall, from the Moose Clan of the Mi'kmaw Nation. It involved inviting the audience to consider topics including interconnectedness, community spirit and respect for difference, and our disconnection from the natural world.

In the afternoon, Debra and I were put to work – running a one-hour workshop followed by a one-hour presentation. Our workshop focused on findings from a study we completed at the start of the year on the implementation of link workers in primary care in England. We encouraged the 100 people who attended to consider the following concepts we developed from this research:

• Micro-discretions: The ability of social prescribing link workers to decide how to act in the role to be able to best support patients. This was often reflected in one-to-one interactions (e.g. how long they spent with patients and how often they met with them, what support they connected people to, what referrals they accepted). Our research suggested that having such flexibility could make link workers feel valued and respected, able to act in a way that best supported patients. However, too much discretion could leave them uncertain and lacking security in the role.
• Holding: Our research found that link workers do not always refer people on to external support (e.g. because there are waiting lists for support such as befriending services, or patients are not at a stage when ready to access community activities or organisations or because the problems faced by individuals could not be resolved by the link worker – such as to do with housing or employment). Without adequate support and acknowledgement, holding could leave link workers feeling emotionally overwhelmed, concerned they were not doing their job correctly (by referring patients on to external support) and reduced their capacity to see other individuals with non-medical needs.

We were interested to hear that these concepts resonated with those delivering social prescribing in the room from Canada. They commented that these were issues they had encountered but not necessarily discussed with others, so they welcomed the chance to do so with colleagues from different parts of the country in the workshop.

Our presentation (which followed the workshop) focused on our on-going TOUS study (Tailoring cultural offers with and for diverse older users of social prescribing) and the use of Storytelling as part of this. We were able to share with those attending our experiences of undertaking this research and learning points, to date, from it. The presentation was well-received, with people coming to talk to us afterwards about the research and our use of Storytelling. Storytelling explores what has meaning for people involved in an activity or event, from their own perspective. It involves talking to them and then condensing their story into a two-page summary (retaining their original words). It also involves sharing and discussing stories with a range of stakeholders to identify, together, the key things to learn from them.

We plan to follow up on the connections we have made in Canada going forwards as there is a lot of potential cross-country learning about social prescribing.

The research mentioned in this blog was funded by the National Institute for Health and Care Research (NIHR130247) and a grant from UK Research and Innovation (MR/Y010000/1). The views expressed are those of the author and not necessarily those of these funders or the author’s host institution.