An article in The Times in October 2022 headlined ‘Prescribing art and gardening for patients may be a waste of money’ may be setting alarm bells ringing in the health and social care sector. The author cites a report published in BMJ Open that reviewed various studies into the outcomes of social prescribing, and concluded there was “no consistent evidence to support the effectiveness of social prescribing link worker interventions” in areas such as health-related quality of life and mental health.

The conclusion drawn as to whether community activities should be prescribed on the NHS – at least by the 554 readers who voted on the associated online poll (as this blog goes to pixel) – was a resounding “no”. Just 31% voted positively.

At first glance, it makes for discouraging reading for organisations (like ours) that provides Social Prescribing Link Workers. It may therefore be a surprise to discover that Public Voice shares a lot of common ground with the study’s conclusions. While The Times article’s headline is unhelpfully reductive, it raises excellent points regarding the true value of social prescribing in delivering positive outcomes and impacts for patients.

It is true that “unregulated social prescribing has the potential for creating harm”, as stated by Imperial College London professor of community psychiatry Peter Tyrer in the article. The nature of the link worker’s role is to help identify complex, connected and often fundamental social issues that contribute to health; and then to help patients navigate those issues, and connect with services (such as public or voluntary) to address them. It is not primarily about sending people to art and gardening activities.

Without clear demarcation of link workers’ roles, as well as the professional practices and knowledge that would be required in a better regulated environment, there is a risk of the time and energy of all involved to be wasted, with poor outcomes for patients and inefficiencies in services.

For this reason, it is vital that link workers are, as suggested by Tyrer, “adequately trained and have a clear therapeutic policy”. Public Voice link workers apply these principles today in practices across North Central London. We are now seeking to help other regions to make the best use of Social Prescribing Link Workers, by applying the best practices we’ve developed.

Ultimately, the interventions of link workers can improve the health outcomes of patients, as well as improving the delivery and efficiency of health and care services in a community. As the director of community health at NHS England James Sanderson comments in the article: “Giving people more control over their own health and empowering patients to look after their own physical and mental health as well as reducing demand on health and social care services”. This is something Public Voice knows from providing not just link workers, but from having helped to define roles for Health and Wellbeing Coaches linked to GPs in North Central London too. And we know and work with many excellent providers of link worker services who share our ambition for a high-quality, regulated practice.

We’re keen to work with stakeholders in the health and care system to ensure consistent, better regulated Social Prescribing Link Worker roles and practices – to maximise the positive impacts for service users, service providers, and the wider community. And if you want to do some gardening, Public Voice supports some excellent volunteer schemes in local communities too.


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