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Timely calls for systematic reforms to embed social prescribing

Introduction by Croakey: Governments and health providers have been urged to boost social prescribing in Australia, and to develop a nationally coordinated approach to support its wider uptake.

People in rural and remote areas, in particular, stand to benefit from a more systematic approach to supporting social prescribing, says the Royal Australian College of General Practitioners (RACGP), in a statement marking International Social Prescribing Day (19 March).

Dr Kuljit Singh, chair of the College’s Specific Interest Group for Social Prescribing, which commenced in 2022, and a Kirra-based GP, said that developing a nationally coordinated approach could also help to ease pressure on hospitals and the wider healthcare system.

“This is a conversation we’re keen to continue having with government because whilst many GPs are doing a great job encouraging the take-up of social prescribing, a formal structure featuring links with GPs to other health professionals and community groups could accelerate social prescribing nation-wide,” said Singh.

RACGP Rural Chair and Townsville-based GP, Associate Professor Michael Clements, said that connecting rural and remote patients to non-clinical, community-based group activities would not only help patients presenting with health conditions but also enhance preventative care efforts and help to develop community resilience and cohesion.

Meanwhile, the Australian Social Prescribing Institute of Research and Evaluation (ASPIRE) has called for the Federal Government to fund Primary Health Networks (PHNs) to lead, coordinate and steward new social prescribing services for priority groups such as older Australians, adolescents, and people with persistent chronic conditions, and/or scale existing services.

In its Federal Budget Submission, ASPIRE also urges the Government to invest in a dedicated Medical Research Future Fund (MRFF) research stream to evaluate models and build the evidence base for integrated health and social care broadly, and social prescribing specifically.

ASPIRE members Professor Yvonne Zurynski, Leanne Wells, and Dr JR Baker write below that “there is much to celebrate on Social Prescribing Day”, but that reforms are needed to maximise the health, social and economic returns.


Yvonne Zurynski, Leanne Wells and JR Baker write:

With the federal election looming, the bipartisan pledge of $8.5 billion bolstering Medicare to improve access to bulk-billed GP consultations is timely as Australians struggle with ever-increasing costs of living and housing unaffordability. No doubt this injection will increase the volume of bulk-billed consultations, at least for a while.

But is it enough to improve long-term health outcomes, or are we just still treating illness rather than building health? Could primary care be done differently to gain even better health and psychosocial outcomes?

On Social Prescribing Day, prescriptions for a walk in nature, gardening club, craft activity, choir, or a game of pickleball could be more routinely embedded into GP consultations to improve health outcomes.

With 15 million Australians living with physical and mental ill-health, and sedentary lifestyles, poor nutrition and loneliness being recognised as important risk factors, social prescribing programs can help.

Emerging Australian research, summarised in a recent review published in PLOS ONE, reinforces what global evidence already shows – social prescribing reduces loneliness, improves mental well-being and enhances quality of life.

In Australia, 15 percent of people report being socially isolated and this is linked to mental illness, suicide, the development of dementia, premature death and poor health behaviours – smoking, physical inactivity, poor sleep, high blood pressure and impaired immune function.

Loneliness is an independent predictor of poor health outcomes. For example, people aged over 70 who are lonely are 42 percent more likely to develop cardiovascular disease.

Less than a quarter of Australians with two or more chronic conditions are offered follow-up and regular GP consultations of more than 15 minutes. Recognising that health is also enabled or inhibited by social and economic circumstances, only a few general practices (13%) usually screen or assess patients for one or more social need. This is likely due to the enormous pressure on our primary care system, GP workforce shortages, increasingly complex patients, an ageing population and increasing rates of mental ill-health.

Embedding social prescribing link workers in general practice would free up GPs to concentrate on the medical aspects of care, while link workers (usually nurses or social workers) worked with the patient to identify their non-medical needs and to co-design a social prescription by linking them with non-medical programs and services in the community.

Social prescribing offers a proactive solution, focusing on the upstream factors that impact health and to keep people healthy and connected with their local community.

This approach isn’t just beneficial for patients – it also alleviated pressure on overstretched GPs and primary care providers.

Seize the opportunity

As members of ASPIRE (Australian Social Prescribing Institute of Research and Evaluation), we feel there is much to celebrate on Social Prescribing Day.

Social prescribing is making significant inroads into primary and community care, with programs being successfully implemented across Australia, mainly through the Australian Primary Health Networks (PHN), for example the SocialRx program in the Illawarra-Shoalhaven.

Social prescribing is showing great promise for families and children too: ASPIRE has been engaged to support the Queensland Government’s Putting Queensland Kids First plan implement a trial across ten neighbourhood centres addressing loneliness and social isolation in vulnerable families.

Social prescribing programs are good for our health. They are also good for the economy. In the UK there is a return of £3.42 per every £1.00 invested in social prescribing, and in Canada it is $4.43 for every $1.00 invested.

Closer to home, an Australian study commissioned by the NSW Government agency icare found a return of $3.80 for every $1 invested in social prescribing programs for injured workers.

This demonstrates that community-based health interventions are not just cost-effective – they generate significant long-term savings for the healthcare system.

However, there is much to do. Our research shows limited evaluations of social prescribing in Australia, with only 10 peer-reviewed published articles identified in our scoping review.

Research and evaluation are important to establish an evidence base about program design, effectiveness, delivery and outcome measures that can be applied in different contexts.

Experts at EACH 24, ASPIRE’s annual conference, called for policy recognition and more widespread investment in social prescribing. There are now many policy documents and recommendations making a robust, evidence-informed case for stable funding and action.

Yet, while the UK already has thousands of social prescribing link workers embedded in healthcare, and the Netherlands is rolling out national models, action in Australia remains fragmented.

If we don’t act now, we risk falling behind on an opportunity to transform our healthcare system.

Eight ways forward

ASPIRE’s Consensus Statement and 2025 Federal Budget Submission urge governments and stakeholders to accelerate social prescribing in Australia while recognising the excellent work that has already begun to flourish.

ASPIRE’s Federal Budget Submission makes eight actionable recommendations:

  1. Invest in a dedicated Medical Research Future Fund (MRFF) research stream to evaluate models and build the evidence base for integrated health and social care broadly, and social prescribing specifically.
  2. Fund an independent national centre to inform social prescribing service development, innovation and delivery, encourage rigorous evaluation, curate data and evidence and support knowledge translation into action
  3. Fund the development of a national online community asset directory to support GPs and link workers to develop appropriate referral pathways for social prescribing
  4. Make provision in the Medicare Benefits Schedule health assessment to remunerate GPs and practice nurses to formulate consumer-led, goal directed social care plans and make social referrals
  5. Support primary healthcare services with access to validated screening and patient activation tools to assist them to triage and target social prescribing services.
  6. Build the social prescribing workforce capability and capacity through the development of education, training, and professional networking support for Link Workers.
  7. Monitor the impact of social prescribing referrals on non-government community service organisations and assure their capacity to accommodate social prescribing services with fundamental measures such as indexation and appropriate levels of funding.
  8. Fund PHNs to lead, coordinate and steward new social prescribing services for priority groups such as older Australians, adolescents, and people with persistent chronic conditions, and/or scale existing services, and undertake capacity building roles to commission and place Link Workers in suitable settings and locations to provide a social prescribing referral pathway for primary healthcare services.

Authors

Yvonne Zurynski (PhD, MHPol, BAppSc, MAppSc) is Professor of Health System Sustainability, Australian Institute of Health Innovation, Macquarie University, Sydney Australia. Her research is focused on health services, health systems, new models of integrated care, learning health systems, and the health workforce. As a mixed methods researcher, implementation scientist, epidemiologist, and policy analyst, her work is highly transdisciplinary and translational. She works collaboratively with health consumers, clinicians, and policy makers to improve care and healthcare experiences for children and families. Yvonne Zurynski is Chair of the ASPIRE’s Health Systems Expert Panel.

Yvonne Zurynski – Research Outputs – Macquarie University

‪Yvonne Zurynski – ‪Google Scholar

Leanne Wells is a health consultant and advocate. She is former Chief Executive Officer of the Consumers Health Forum of Australia. She is a Board Director of the Australian Commission on Safety and Quality in Healthcare and the South Eastern NSW Primary Health Network. She is a member of the RACGP’s Funding and Health System Reform Committee and Chair of ASPIRE’s Consumer and Community Expert Panel.  She has collaborated as a consumer adviser and system lead on several research projects including with the Australian Institute of Health Innovation, Macquarie University.

‪Leanne Wells – ‪Google Scholar

J.R. Baker (PhD, MPsych, PGDipPsych, BA) is Chair of the Australian Social Prescribing Institute for Research and Education (ASPIRE), an Adjunct Associate Professor at Southern Cross University, and the CEO of Primary & Community Care Services (PCCS). He has implemented and researched social prescribing models in Australia for over a decade and has been recognised with multiple awards for this work, including the Banksia Award for Sustainability and multiple Good Design Awards. J.R. also serves on the Boards of the Bobby Goldsmith Foundation (BGF) and Queensland Alliance for Mental Health (QAMH).

J.R. Baker – Google Scholar


See Croakey Conference News Service’s detailed coverage of the International Social Prescribing Conference last year

https://www.croakey.org/wp-content/uploads/2024/08/CCNS_EACH24_Report.pdf

 

 

 

 

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TOO MUCH of a Good Thing
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