The potential for social prescribing to contribute to better health and wellbeing has been highlighted in Croakey’s coverage of an international conference on social prescribing over the past month.
Below, conference participants share reflections about what they learnt and will take forward from the discussions, including about “the importance of planetary health, ensuring that our infrastructure and interactions include nature-based interventions and create environments where societies can socialise and thrive”.
Beneath their comments are details of the #EACH24 analytics on X/Twitter, showing 82 accounts contributed a total of 1,520 posts, as well as links to recent publications on the role of social prescribing in supporting carers and suicide prevention.
Q: What was something at the conference that was unexpected or surprised you?
Dr Moira Dunsmore, Senior Lecturer Primary Health Care|Theme Group Lead – Social Contexts of Health, Susan Wakil School of Nursing & Midwifery|Sydney Nursing School, University of Sydney: I was amazed at the number of academics at the conference who were already using social prescribing in so many diverse ways. I am fairly new to this and speed that social prescribing has taken off here suggests there is a strong need.
Robin Mellon, CEO, Better Sydney: I was blown away by the sheer diversity of professions and skills in the room, as well as the years and years of clinical, practical experience. There were doctors and nurses and psychologists and occupational therapists and data scientists and researchers and community experts and librarians and counsellors and social workers and everyone in between – all of whom agreed on the importance of social prescribing and collaboration.
Leanne Wells, health consultant and advocate, Chair, ASPIRE’s Consumer and Community Expert Panel: I’ve tended to think of social prescribing in terms of its value and capacity to integrate with health services – principally primary care.
We shouldn’t under-estimate the passion and interest in embracing social prescribing in the community, disability and aged care sectors and as well as across a broad spectrum of workforce. They might not call it ‘social prescribing’ but there is much practice already underway and embedded in these sectors. This was firmly on show at the conference.
The conference reinforced that when we talk about acceleration in Australia it is not so much momentum in service delivery that is needed, although a more equitable array of services is essential. We are talking about the need for ‘change enablers’, that is, national systems and infrastructure to improve, embed and sustain services, explore further innovation and assess impact. This includes strategies such as minimum data sets, education curriculum, workforce development, integrated models and structured communities of practice.
Participants weren’t demanding major investments and ambitious, large-scale rollout. There was a pragmatism in the conversation and an acceptance that incrementalism is OK: embracing the 80/20 rule allows the system to start somewhere, learn and improve over time. They were asking for policy makers’ recognition that social prescribing has a place in health and social care policy implementation.
Victoria Sullivan, PhD Candidate, The Centre for Community Health and Wellbeing at Springfield, Queensland, University of Queensland: The Glasshouse at the State Library and the Museum of Contemporary Arts were inspired venues for the conference. I really enjoyed the experiential social prescriptions. The forest therapy in the Botanic Gardens involved a range of practices designed to explore and experience nature. I loved it!
Tracey Johnson, Chief Executive Officer, Inala Primary Care: The work of the NSW Art Gallery around social prescribing was far better than I expected. The work of the Botanical Gardens groups going out and about NSW creating community gardens was also wonderful to hear about.
The launch of “Join or Die” was fabulous. Very moving documentary and very thought provoking. Inspirational researcher whose work I have come across before but nice to put it all in context.
Dr Christina Aggar, Associate Professor Nursing, Southern Cross University, Conjoint Northern NSW Local Health District: I had never participated in an arts session – I thoroughly enjoyed and felt very relaxed afterwards.
Associate Professor JR Baker, CEO, Primary & Community Care Services; Adjunct Associate Professor, Faculty of Health, Southern Cross University; CEO, Australian Social Prescribing Institute of Research and Education: One of the most pleasant surprises at the ASPIRE Conference was seeing how engaged attendees were with their surroundings and the city of Sydney. We designed the conference to encourage walking between various parts of the city, exposing participants to green and blue spaces, as well as creative and cultural areas.
It was truly heartening to hear that people felt present, connected, and part of the beautiful city of Sydney. I was also thrilled to see the enthusiasm from stakeholders outside traditional healthcare settings, as they considered everything from health equity to environmental well-being and planetary health. This broader perspective was quite refreshing.
Q: What was something that you learnt?
Tracey Johnson, Chief Executive Officer, Inala Primary Care: How novel health justice partnerships were to the audience. I had imagined more people would have heard about them.
Robin Mellon, CEO, Better Sydney: That everyone in the room had a different piece of the jigsaw, and that everyone worked diligently on ensuring their piece of the jigsaw was well-maintained and available, but when they put them all together there was a compelling, data-driven picture of a healthier, more connected, more contented Australia.
Leanne Wells, health consultant and advocate, Chair, ASPIRE’s Consumer and Community Expert Panel: I learnt that:
- Collectively we have more practice and more data about social prescribing than we know – it needs to be brought together systematically.
- Social prescribing is both global and local at the same time. There is a global wave of social prescribing advocacy, implementation and uptake with much knowledge being shared across global alliances. But social prescribing and its value needs to be understood in terms of complex national, state and even regionalised systems where effective implementation of local models is essential.
- Social prescribing can be both universal and personalised. Medicare is Australia’s universal public health insurance scheme. In a November 2023 speech to the Whitlam Institute the Minister for Health spoke about his desire to strengthen Medicare beyond its health insurance roots to include the principles of community health care rather than sick care. And by its very nature, social prescribing is people-centred and personalised. Social prescribing practitioners consistently spoke of the key question they ask: “what matters to you?”. The answer to this is fundamentally what drives the nature and scope of an individual’s social prescription.
Victoria Sullivan, PhD Candidate, The Centre for Community Health and Wellbeing at Springfield, Queensland, University of Queensland: Hearing about different projects and studies reminded me how vast and geographically and culturally diverse Australia is. Coming from England (small country), I sometimes find it hard to grasp the distances between communities and how that may affect the availability of services, community resources, and opportunities that enable health and wellbeing.
Dr Christina Aggar, Associate Professor Nursing, Southern Cross University, Conjoint Northern NSW Local Health District: That there is increasing interest in the benefits of social prescribing to support family/informal carers’ wellbeing.
Dr Moira Dunsmore, Senior Lecturer Primary Health Care|Theme Group Lead – Social Contexts of Health, Susan Wakil School of Nursing & Midwifery|Sydney Nursing School, University of Sydney: The focus was truly multidisciplinary – crossing multiple sectors of health, as well as the arts, and using co-production and co-design methods (an area of interest to me) that promote inclusion.
Associate Professor JR Baker, CEO, Primary & Community Care Services; Adjunct Associate Professor, Faculty of Health, Southern Cross University; CEO, Australian Social Prescribing Institute of Research and Education: I found it reassuring to observe variations in the levels and numbers of social scripts among different participants. Some might see this as a drawback, but it made me reflect on the necessity to persist in addressing social determinants until the individual finds activities that truly matter to them. The prescription process doesn’t always succeed on the first attempt. That’s not necessarily a reflection of complexity or challenge but rather of persistence in achieving desired outcomes.
It was also enlightening to hear about the UK and Canada’s work in social prescribing for young people. This highlighted the inadequacies of our current systems in dealing with family dynamics and moving beyond individual care models. The challenge lies in quantifying, governance, funding and coordinating efforts across teachers, coaches, parents, children, and activities within an ecosystem that isn’t traditionally set up for such comprehensive integration. While the challenges in implementing social prescribing programs for children and youth are the same for adults, I was reminded that that many of our adult models neglect the kind of context and system someone sits within.
Q: Is there anything you will do differently as a result of the conference?
Robin Mellon, CEO, Better Sydney: Personally, join more groups and practically insist that my family members and friends and colleagues do the same – the message of ‘Join or Die’, and Robert Putnam’s work, and of all the professionals around the room, was that connection, community and collaboration was key to a healthy and fulfilled life.
Victoria Sullivan, PhD Candidate, The Centre for Community Health and Wellbeing at Springfield, Queensland, University of Queensland: It was great to see so much interest in social prescribing from the healthcare practitioners and Primary Health Networks in attendance. This boosted my confidence to contact the PHN where I am based and share more details about my Nature Prescription research.
Dr Christina Aggar, Associate Professor Nursing, Southern Cross University, Conjoint Northern NSW Local Health District: I think I will make a point of clearly stating what Social prescribing is and what it isn’t to healthcare professionals in the future.
Dr Moira Dunsmore, Senior Lecturer Primary Health Care|Theme Group Lead – Social Contexts of Health, Susan Wakil School of Nursing & Midwifery|Sydney Nursing School, University of Sydney: I want to steer my research more towards social prescribing as part of the solution; my focus, older persons with sensory impairments, lends itself well to using social prescribing in innovative ways.
Associate Professor JR Baker, CEO, Primary & Community Care Services; Adjunct Associate Professor, Faculty of Health, Southern Cross University; CEO, Australian Social Prescribing Institute of Research and Education: It was incredibly motivating to hear from passionate researchers and academics. I was inspired by colleagues, such as Professor Brydie-Leigh Bartleet and Dr Candice Oster, speaking about creating better systemic equity. The level of creativity depicted in Professor Evonne Miller and Professor Robyn Clark’s presentations ranged from painting cricket stumps on wheelie bins, to activating entire communities with arts and culture, through to using music to address social barriers and well-being.
One creative project of Professor Katherine Boydell used Fine Arts students’ social messages in art installations with applied health research. Seeing it in practice was brilliant. It encouraged me to explore novel ways of engaging with communities and co-creating stories that reflect their aspirations for the future.
Tracey Johnson, Chief Executive Officer, Inala Primary Care: I am travelling to Canada next year with work and will be connecting with a few folks there who are doing interesting work.
Q: What were the key messages you took away from the conference?
Tracey Johnson, Chief Executive Officer, Inala Primary Care: Social prescribing is maturing. It is diverse so needs connection across government. There are many ways of measuring success which are easy to gather depending upon the type of social prescribing activity. We need some nationally agreed things to track across program types to justify this becoming mainstream.
Robin Mellon, CEO, Better Sydney: Partnership is the new leadership – coming together to ensure better collaborative outcomes is not always easy but develops amazing innovation, extraordinary outcomes and long-term benefits for individuals, communities and care-givers.
Leanne Wells, health consultant and advocate, Chair, ASPIRE’s Consumer and Community Expert Panel: Three main messages were reinforced for me:
- There is growing acknowledgement that if we are to improve health outcomes, we need to rebalance where we put our efforts. Many including the Minister for Health and Health Department Secretary have spoken about putting the social determinants into Medicare; and
- The time is now for social prescribing. We have several national and state-level governments looking to better integrate health and social care and an unprecedented number of policies with this as an explicit goal.
- Place-based implementation really matters. Only by responding to local needs, co-designing with local clinicians and community members, and working in collaboration with the existing service architecture will implementation succeed. There is a fundamental role for PHNs and the Aboriginal Community Controlled Health sector here.
Victoria Sullivan, PhD Candidate, The Centre for Community Health and Wellbeing at Springfield, Queensland, University of Queensland: There is a lot of interest and enthusiasm for further developing and embedding social prescribing in Australia. Hearing from the wide range of researchers, practitioners and community members reminded me of the importance of contextualising social prescribing to your locality and ensuring projects are community-led. This is not a one-size-fits-all initiative.
Dr Christina Aggar, Associate Professor Nursing, Southern Cross University, Conjoint Northern NSW Local Health District: Social prescribing is increasingly being recognised as a key strategy to support wellbeing.
Dr Moira Dunsmore, Senior Lecturer Primary Health Care|Theme Group Lead – Social Contexts of Health, Susan Wakil School of Nursing & Midwifery|Sydney Nursing School, University of Sydney: That implementation of social prescribing will be an important area of development in the future and that SP will work well with some of the broader government policies and aspirations for older adults.
Associate Professor JR Baker, CEO, Primary & Community Care Services; Adjunct Associate Professor, Faculty of Health, Southern Cross University; CEO, Australian Social Prescribing Institute of Research and Education
Key takeaways from the conference include the necessity to collaborate across different governance systems with different drivers, and the development of shared metrics for meaning and success. It is crucial to move towards a well-being economy, rather than measuring individual funding streams and traditional cost benefit analysis. The latter narrowly focuses on financial inputs and outputs without capturing the broader social and environmental benefits.
Additionally, there’s significant potential to streamline social prescribing processes and improve data collection through digital innovations and consistent practices across regions, governments, agencies, and organisations.
The conference also reaffirmed the importance of planetary health, ensuring that our infrastructure and interactions include nature-based interventions and create environments where societies can socialise and thrive.
Overall, the conference was a testament to the delegates’ collective goodwill and commitment to advance community well-being, locally and nationally. The generosity and kindness shown was outstanding. While many people have been pushing the concept of social prescribing for many years, the growing support base gives hope for meaningful progress in the coming years.
Was there anything missing, or that you would have liked to have heard more of?
Tracey Johnson, Chief Executive Officer, Inala Primary Care: So much. There were so many great sessions. This is a growing community with diverse views. The interest by consumers in not having it called social prescribing is understandable but the horse has bolted. We just need to popularise the language.
Robin Mellon, CEO, Better Sydney: I would love to have heard more case studies like the Pinnaroo Project – real-world examples of communities that had demonstrated real change over time.
Victoria Sullivan, PhD Candidate, The Centre for Community Health and Wellbeing at Springfield, Queensland, University of Queensland: I would have liked to have heard a bit more about the ‘how’ of social prescribing. The quality of the conversation between the practitioner and the individual is critical to ensure people feel able to share their needs and aspirations and build on their strengths. This requires a specific skillset that facilitates more meaningful conversations.
Dr Moira Dunsmore, Senior Lecturer Primary Health Care|Theme Group Lead – Social Contexts of Health, Susan Wakil School of Nursing & Midwifery|Sydney Nursing School, University of Sydney: As a first timer, I felt this conference covered a lot – including what, how and why. There were excellent key notes and a broad range of application to health and social care for diverse population groups.
Associate Professor JR Baker, CEO, Primary & Community Care Services; Adjunct Associate Professor, Faculty of Health, Southern Cross University; CEO, Australian Social Prescribing Institute of Research and Education: The Pinnaroo project in South Australia was fantastic. It highlighted how community passion projects can enhance health, well-being, social connection, and inclusion.
For our next conference, it would be great to see more examples of social prescribing in rural and remote areas, including digital and face-to-face interventions to address inequities. I’d also like to hear more about the individuals driving social prescribing changes in different contexts and settings. Understanding their leadership strategies, especially for addressing systemic barriers to well-being for equity-denied groups, could provide valuable insights.
Another area of interest is better integration of social prescribing into Australia’s healthcare system. Current messaging often overlooks the diverse array of activities beyond park walks and fun runs. Expanding discussions to include a diverse range of activities, like heritage, culture, art, environment, education, and volunteering, provides a more holistic, social and emotional wellbeing model. Learning from First Nations peoples’ comprehensive approach to community well-being, acknowledging kinship, country, and culture, is essential.
Q: With the escalating climate health emergency, how might social prescribing contribute to climate action?
Tracey Johnson, Chief Executive Officer, Inala Primary Care: Many ways…gardening groups and walking groups, etc will impact the way people behave so that we reduce climate impact. Of course there are also lobby groups and interest groups which people could join as part of a social prescribing plan which will get them connected, doing purposeful stuff and addressing this need. Even as healthcare needs rise, the role of volunteers in healthcare really needs expansion so there are many touchpoints.
Robin Mellon, CEO, Better Sydney: Community-empowered projects (communities coming together to re-wild areas, replant vegetation, increase urban canopy, preserve biodiversity regions, or around particular projects like community solar or community gardens) stand an amazing chance of achieving the ‘global-to-local’ outcomes that are needed from the 17 UN Sustainable Development Goals to our local neighbourhoods, working across “just” social / economic / environmental actions and outcomes to achieve the ‘healthy economy within a healthy society within a healthy environment’ goal that is a reversal of ‘triple bottom line’ economic thinking.
Leanne Wells, health consultant and advocate, Chair, ASPIRE’s Consumer and Community Expert Panel: Equipping people with social prescriptions can contribute to their wellbeing, mental health and resilience. Resilient communities which can mobilise quickly have been shown to be essential to the way in which they respond and recover from the impact of climate-related natural disasters such as bushfires and floods.
Victoria Sullivan, PhD Candidate, The Centre for Community Health and Wellbeing at Springfield, Queensland, University of Queensland: There is so much potential for social prescribing initiatives to support climate action. By focusing on preventive health, social prescribing reduces the need for resource-intensive medical interventions and pharmaceuticals.
Health outcomes and environmental benefits can/should be aligned whereby health-promoting activities, (for example, community gardening or active travel), are delivered locally and always considered in the context of their environmental impact. Social prescribing initiatives also have community reach; fostering cross-sector partnerships to address the direct impact of climate events and proactively building climate-resilient communities.
On a more fundamental level, social prescribing can reorient our relationship with nature to cultivate respect and nature (re)connection. This may be via specific nature prescription initiatives, building environmental literacy through connection with conservation groups and activities, and advocating for equitable access to quality green/blue spaces.
Dr Christina Aggar, Associate Professor Nursing, Southern Cross University, Conjoint Northern NSW Local Health District: I live in the Northern Rivers area in NSW, and social prescribing would be beneficial to support people from the very beginning of a disaster.
In relation to how social prescribing can address climate change: promoting sustainable activities that have a lower environmental impact, such as community gardening and walking groups, or cycling clubs. These activities reduce reliance on carbon-intensive modes of transport and promote greener practices. Building resilient more connected communities by linking individuals to local groups and support networks and encouraging collaborative efforts in climate adaptation and mitigation.
Prescribing nature-based interventions, such as nature walks or conservation volunteering, may foster a deeper connection to the environment and motivate individuals to support and engage in climate action. Social prescribing can include education and resources on climate-friendly practices, such as reducing waste, conserving energy, or sustainable eating. This information empowers individuals to make environmentally conscious choices in their daily lives.
Associate Professor JR Baker, CEO, Primary & Community Care Services; Adjunct Associate Professor, Faculty of Health, Southern Cross University; CEO, Australian Social Prescribing Institute of Research and Education: Social prescribing can significantly contribute to climate action by promoting activities that support both mitigation and adaptation. Green social prescribing can involve community participation in local environmental projects, such as tree planting and conservation, enhancing carbon sequestration and biodiversity. By fostering a connection to nature and sustainable practices, social prescribing can raise climate awareness and inspire environmentally friendly lifestyles. Strengthening social networks through social prescribing bolsters community resilience, crucial for adapting to climate impacts.
Notable work by Professors Xiaoqi Feng and Thomas Astell-Burt focuses on reducing “lonelygenic” environments by creating urban areas rich in green spaces and opportunities to interact with other people as well as the environment. Their research highlights the importance of urban planning and environmental design in promoting social connections and sustainability.
Q: What do you hope might have changed for the field of social prescribing by the time of the next conference?
Tracey Johnson, Chief Executive Officer, Inala Primary Care: For the first time there were more government folks there. I think we are getting info out and getting attention. Creating broader awareness of what is possible is also invaluable.
Robin Mellon, CEO, Better Sydney: Great political awareness of the benefits, and a Minister or Commissioner for Social Connection. The UK already has a Minister for Loneliness; Australia needs a Minister for Social Connection.
Leanne Wells, health consultant and advocate, Chair, ASPIRE’s Consumer and Community Expert Panel: That a national social prescribing initiative has been funded under Strengthening Medicare.
Victoria Sullivan, PhD Candidate, The Centre for Community Health and Wellbeing at Springfield, Queensland, University of Queensland: It would be great to see a sustainable funding model that enables social prescribing services to be embedded in communities across Australia. Sustainable funding avenues for community-based activities, groups and community venues that people are connected to, are another critical part of the process.
Dr Christina Aggar, Associate Professor Nursing, Southern Cross University, Conjoint Northern NSW Local Health District: Strategies to promote, engage and educate Link Workers.
Dr Moira Dunsmore, Senior Lecturer Primary Health Care|Theme Group Lead – Social Contexts of Health, Susan Wakil School of Nursing & Midwifery|Sydney Nursing School, University of Sydney: I hope that we can capitalise on the current wave of enthusiasm for social prescribing to embed this is primary care and seen as important as other forms of health and social care.
Associate Professor JR Baker, CEO, Primary & Community Care Services; Adjunct Associate Professor, Faculty of Health, Southern Cross University; CEO, Australian Social Prescribing Institute of Research and Education: By the next conference, I hope we will have made considerable progress in standardising educational standards for link workers as well as establishing a national minimum dataset for measuring social prescribing outcomes and impacts. While local implementations will want to measure specific aspects unique to their social prescribing initiatives, collecting these datasets will help build future evaluation frameworks that could be widely adopted.
I also hope social prescribing will be more deeply integrated into mainstream healthcare systems, with increased funding and policy support from all government levels. I anticipate seeing more widespread adoption of social prescribing across Australia, including the increased use of digital platforms to enhance the efficiency and accessibility of social prescribing.
One big challenge to overcome is mapping very local resources that might not currently exist on any service directories while also providing access to national infrastructure that helps improve quality of life.
In the coming year, I’ll be intrigued to see how local and national service directories, evaluation metrics, and education develop and how different sectors embed social prescribing into their work.
Q: Would you like to make any other comments, whether about the conference itself or social prescribing?
Tracey Johnson, Chief Executive Officer, Inala Primary Care: The ASPIRE network is a critical element of Australia’s response to growing isolation, loneliness and loss of purpose as our population ages and becomes more multicultural and intergenerational. We need avenues for sharing data, approaches, creating professional connections and coherence in strategies so that collective resources can be applied. Sharing data and lessons learnt builds the corpus of knowledge which will accelerate implementation. It also takes social prescribing away from being a “soft and poorly dimensioned” activity into the hard science of responding to social determinants and improved service delivery.
Robin Mellon, CEO, Better Sydney: Social prescribing is the ‘how’ – how we get to the better outcome. We need to be better at telling the story about the outcome – what it is that we’re trying to get to. And then demonstrating that this is the most effective, efficient, cost-productive and community-connecting way of getting there.
Dr Moira Dunsmore, Senior Lecturer Primary Health Care|Theme Group Lead – Social Contexts of Health, Susan Wakil School of Nursing & Midwifery|Sydney Nursing School, University of Sydney: Great venue, inclusive atmosphere and a sense of genuine excitement about the role SP can play in health and social care.
Associate Professor JR Baker, CEO, Primary & Community Care Services; Adjunct Associate Professor, Faculty of Health, Southern Cross University; CEO, Australian Social Prescribing Institute of Research and Education: The conference was an excellent platform for sharing knowledge and best practices in social prescribing. It highlighted the growing global momentum behind this movement and its diverse applications for improving health and well-being. I’m optimistic about the future of social prescribing and its potential to transform healthcare by addressing social determinants of health holistically. The collaborative spirit and innovative ideas presented at the conference have energised me to advocate for social prescribing across Australia in the coming year.
Recent publications
Analytics
The summary slide below is from a Tweetbinder analysis for the period 11 May-7 August, 2024 (a searchable online version is here).
Bookmark this link for Croakey Conference News Service’s coverage from #EACH24 and follow this X/Twitter list. An e-publication will be published in due course.
