What is the potential role of community pharmacists in social prescribing?

The World Health Organisation (WHO) defines health as ‘’a state of complete physical, mental and social wellbeing and not merely the absence of a disease or infirmity.’’ This highlights the importance of the wider determinants of health; up to 40% of health outcomes have been linked with socioeconomic factors. A report from Citizens Advice showed that up to 20% of cases seen by general practitioners (GPs) in England were for non-medical related matters such as relationship issues and housing problems. To address these, social prescribing has become a major aspect of National Health Service (NHS) policy and practice, to ensure that person-centred care is provided, whilst also reducing the time spent by GPs on non-medical issues, repeat hospital attendance and admissions.

Definition of social prescribing

Social prescribing has been described as “a way of linking patients in primary care with sources of support within the community to help improve their health and well-being.”  It aims to address wider determinants of health by connecting people to voluntary organisations and community groups offering activities that could improve health and wellness. Examples include gardening, arts and museum visits, reading groups, cooking clubs, sports and exercise, music/singing and benefits advice.

Social prescribing in action

The social prescribing pathway usually begins with a referral from a GP, health professional or other providers, to a social prescribing coordinator (often referred to as a link worker). Self-referral may also be possible. The link worker meets the individual to find out what matters to them in terms of their health and well-being. They then co-produce an action plan that includes suitable activities or avenues of support, often offered by local, voluntary, community and social enterprise (VCSE) groups. The link worker follows up the individual during the process and may refer a person back to a health professional if they feel that medical intervention is required.

Is there a role for pharmacists in social prescribing?

The NHS England Long Term Plan is committed to building the social prescribing infrastructure in primary care. It is expected that 1,000 new social prescribing link workers will be in place by 2020/21 and at least 900,000 people will be referred to social prescribing by 2023/24. This is part of the drive to achieve NHS England’s Universal Personalised Care goal which estimates at least 2.5 million people will be more involved in their care by 2023/24.

There has been a call for more health professionals, including pharmacists, to become involved in social prescribing referrals. This is to meet increasing social needs (expected to rise further with the aftermath of the COVID-19 pandemic). Community pharmacists may be well placed to support this call for several reasons, including:  

• Pharmacists are often based in the community, so are easily accessible, as patients do not need to book appointments;
• Pharmacists have the required knowledge of communication and interpersonal skills for social prescribing from their training;
• Pharmacists usually develop a strong relationship with their patients, so may be able to identify people who could benefit from social prescribing.

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A recent study, exploring the knowledge of pharmacists and pharmacist technicians on social prescribing, showed that although most respondents lacked experience with social prescribing, they had a good understanding, showed enthusiasm to be involved and felt confident in identifying people who could benefit. Additionally, the study found about 5% of respondents had been involved in a social prescribing scheme. Funding and training were identified as barriers to involvement.

Further exploration and evaluation of the potential role of pharmacists in social prescribing is needed. Better training in mental health, wellbeing and public health, alongside knowledge of local support, may be required to make this a reality. However, engaging community pharmacists in social prescribing is a viable means of extending the reach of social prescribing by wider community health team members. 

Oluwafunmi Akinyemi (oluwafunmi.akinyemi@phc.ox.ac.uk) is working on a project that is funded by the National Academy for Social Prescribing. The views expressed in this blog are those of the author and not necessarily those of her host institution, the NIHR or the National Academy for Social Prescribing.