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'Social prescribing': The new way doctors can prescribe gym visits, transportation—and even housing

January 31, 2019

    Editor's note: This is part of a series about care transformation around the globe, where we look at successful population health managers outside the United States. In this post, we highlight how organizations across Europe and Canada are popularizing the concept of social prescribing. A version of this post previously ran on The Forum.

    By now, population health leaders have a good understanding of how to address the major social determinants of health—such as housing, food, and transportation. However, provider leaders and frontline staff, like community health workers, know that patients have some non-clinical needs that can't be met by traditional social service agencies. How can population health departments address patients' less-tangible non-clinical challenges, like social integration and self-fulfillment, which still significantly affect patients' lives?

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    Across Europe, provider organizations have adopted the concept of social prescribing, which aims to address lifestyle behaviors and non-clinical needs.

    What is social prescribing?

    Social prescribing is the act of health care professionals referring patients to services to improve their health and wellbeing. It has long existed in many European countries (notably, Scandinavia and the UK), but it is just now making its way to the rest of the world. For example, just a few months ago, a social prescribing pilot called Rx: Community launched in Ontario, Canada, linking U.K. experts to 11 Canadian Community Health Centres building out their own linkages between primary care and the social sector.

    While social prescribing can be sophisticated, many systems start small. The most common starting point is a simple, often non-electronic, referral system between the clinical and nonprofit sectors. It is then up to the patients to go and get their "prescription" filled at a range of services, such as counseling, art classes, community groups, or personal training.

    Social prescribing innovation in today's health care landscape

    Unfortunately, this referral-only form of social prescribing is becoming difficult to deliver on. Populations are becoming older and more complex as health and social care funding is plateauing. Many social agencies are unable to meet increased demand.

    Voluntary Action Rotherham (VAR) in the U.K. is tackling this sustainability challenge. VAR is an English charity that leads the support and development for Rotherham's nonprofit and community sector. Not only does VAR have a robust referral system between PCPs and approximately 1,400 nonprofit organizations, but the organization also funds frontline care at roughly 20 of the most popular organizations. This means VAR is simultaneously creating capacity in social care while increasing referral volume.

    VAR serves as the single gateway for providers and their patients to access the nonprofit sector. This means that PCPs, nurses, and other clinicians aren't being asked to extend beyond the scope of their expertise. Because of this, VAR managed to gain buy-in from 100% of the area's PCPs just months into its 2012 pilot. Since then, VAR has sent 5,000 referrals to the social sector, resulting in almost £650,000—or about $850,000—in avoided health care costs and a 42% reduction in ED use among previously high-utilizers.

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