Primary care at the heart of social prescribing national rollout

‘The time is right for social prescribing to be supported in Australia.’
 
That is Professor Mark Morgan from Bond University, who represented the RACGP at a recent roundtable event on 29 February, hosted by the Australian Social Prescribing Institute of Research and Education (ASPIRE) at the National Press Club in Canberra.
 
The ‘Accelerating Social Prescribing’ roundtable, attended by more than 50 health, consumer and social wellbeing organisations, emphasised the critical role of social prescribing in primary care, calling for this to be the starting point for a nationwide implementation of the model of care.
 
In the roundtable opening statement, Assistant Minister for Health and Aged Care Ged Kearney said social prescribing is ‘an exciting frontier in the health sector’ and ‘charts a new way forward for healthcare that better connects patients with community services and programs, empowers and
support patients to better manage their health and wellbeing’.
 
A key objective of the roundtable was to support nationwide implementation through an accompanying Consensus Statement, released on 14 March to mark World Social Prescribing Day.
 
‘The headline from the plenary session was the desire to see an Australian social prescribing system sit in parallel to the healthcare system, and deeply connected with primary care,’ Professor Morgan, who is also Chair of the RACGP’s Expert Committee – Quality Care, told newsGP.
 
‘The roundtable explored how a social prescribing system would need national policies and modest funding to ensure the areas with most need are not missed.
 
‘There was rich discussion about the partnerships that would need to be formed at a local and regional level to implement social prescribing that will work across all the variety of Australia.
 
‘There was also a key principle to grow and enrich social prescribing that is already popping up around the country.’
 
Social prescribing has seen a recent boom in Australia, with mental health concerns remaining the most common presentation in general practice since 2017, and many GPs already using it as a tool to help combat an ongoing loneliness epidemic. The RACGP also launched a dedicated Specific Interests group in March 2022 to match a growing appetite for the area of health.
 
But in order for social prescribing to reach its full potential, Professor Morgan says several policy actions are needed that align with the recommendations in the Consensus Statement.
 
ASPIRE is calling on the Federal Government to commit to social prescribing as a part of a broader strategy to address the social determinants of health, saying it should be the principal funder of a national expansion, which could tie in with efforts to strengthen and modernise Medicare.
 
This includes existing policies and infrastructure investments on which social prescribing can build and integrate, ongoing funding for existing Primary Health Networks (PHNs) and Aboriginal Community Controlled Health Organisations (ACCHOs), and adjustments to Medicare and other funding arrangements to enable the ‘rapid, equitable, contextualised and widespread deployment’ of social prescribing.
 
‘The Government should be the main funder so people get the most benefit,’ Professor Morgan said.
 
‘In Australia there is a big emphasis on funding hospitals and sub-specialist services with only 7% of health funding on general practice and only 2% of health spending on prevention.
 
‘At the local level, social prescribing needs a lot more than just a well-maintained database of available community groups and activities.’
 
The Statement also calls for a model that includes ‘link workers’ commissioned through PHNs and ACCHOs, which Professor Morgan says were identified as having ‘the most potential’ to drive these partnerships and protect what is already working well.
 
‘All the experience nationally and internationally has demonstrated the benefits of link workers,’ he said.
 
‘Link workers can help assess a patient’s needs, aspirations, goals and capacity. They can match this to available community groups or activities and then provide the necessary assistance to get started. They can follow up and adjust the “social prescription” as needed.
 
‘Link workers should be available for every GP and practice nurse. One model is for PHNs to commission link workers.’

(L–R) Professor Xiaoqi Feng, Associate Professor JR Baker, Professor Rosemary Calder, Tracey Johnson, Professor Mark Morgan, Dr Sam Manger, and Dr Kuljit Singh at the social prescribing national roundtable event in Canberra. (Image supplied)

While ASPIRE acknowledges social prescribing could be introduced in a variety of settings, it has focused on primary care as the starting point for an Australia-wide implementation, given its trust among the community and frequency of access.
 
Professor Morgan says GPs are perfectly placed, with the RACGP initiating a national conversation around social prescribing in 2019 alongside the Consumers Health Forum and NHMRC Partnership Centre for Health System Sustainability.
 
‘We have a perfect storm of increased mental illness and more people than ever experiencing loneliness since the COVID pandemic,’ he said.
 
‘We have a health system struggling with a mismatch between demand and workforce. We have increasing shift away from people meeting others in the community because of the convenience of staying home to access streaming, social media and online shopping.
 
‘There are only tenuous links between local council and community services and the health system, despite clear evidence that many of the people who see us in general practice do so, at least in part, because of social issues.’

Professor Morgan believes the ASPIRE Consensus Statement marks a step forward in addressing the need for social prescribing to become ‘a part of the fabric of the Australian community’, and is the start of a movement capable of lifting both health outcomes and quality of life, while simultaneously improving the experience of delivering healthcare and strengthening communities.
 
‘Integrating social prescribing will enable people everywhere to benefit from connection to affordable, local groups and activities to improve health and wellbeing,’ he said.
 
‘Ultimately, the Statement calls for a health system that emphasises prevention rather than just treatment.
 
‘But I see the social prescribing system as a way to build communities and bring back the village. I see it as a way for people to reconnect, contribute through volunteering and to add meaning to lives.
 
‘Through that, and of course physical activity, I see social prescribing as a tool to better health.’
 
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