Pharmacists and Social Prescribing

RPS position statement to raise awareness and encourage appropriate referrals

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Social Prescribing Link Workers (SPLWs) are frontline non-clinical health professionals working at an individual and community level. They are part of the Multi-Disciplinary Team (MDT) delivering personalised care to people, giving them time to discuss what matters to them from a holistic perspective and enabling them to take control of their health and wellbeing, and connecting them to the right support.

They focus on improving the health and wellbeing of individuals and communities through preventative care, self-management, social justice, the reduction of health inequalities, and an understanding of the wider (social, economic, and environmental) determinants of health.

They take referrals from the PCN’s Core Network Practices and a wide range of agencies, including pharmacies, wider multidisciplinary teams, hospital discharge teams, allied health professionals, fire service, police, job centres, social care services, housing associations, and voluntary, community and social enterprise (VCSE) organisations (list not exhaustive).

With sufficient resources and numbers of SPLW working alongside primary care and community services, they can relieve the burden of care, effectively utilise limited resources, and improve health outcomes, positively impacting marginalised individuals and communities.

Pharmacy is the third-largest healthcare profession. Pharmacists working in all areas of practice should be encouraged to refer to social prescribing link workers for the good of patients and the public, and processes need to be put in place to support this. Using pharmacists in social prescribing is of benefit to the health and wellbeing of the population as a whole.

Pharmacists are experts in medicines and their use, but also play a significant role in prevention and supporting non-medical interventions to support people’s care.

Pharmacists are part of multidisciplinary teams working across primary and secondary care, and can play a significant role in identifying and referring individuals who would benefit from social prescribing.

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Supporting joint working

Pharmacists, and members of the pharmacy team, are included in multidisciplinary teams and as part of that, they have the opportunity to identify and refer people who would benefit from a social prescribing referral. 

Currently, there is little evidence of the involvement of pharmacy in social prescribing referrals across the country. Pharmacists could use the opportunities of structured medication reviews, discharge medicines service or the new medicine service to identify people who would benefit from a referral to a link worker. 

People who attend community pharmacies frequently may also benefit from a social prescribing referral.

Supporting reductions in health inequalities

Addressing health inequalities has been identified as a key priority in the NHS Long Term Plan, which includes new actions to help people stop smoking, overcome drinking problems, and prevent Type 2 diabetes.

Community pharmacists and their teams can play their part in helping to address health inequalities, given they are well established in the community and have a good understanding of the needs and challenges facing local populations. There is the opportunity to capitalise on day-to-day engagement with patients and the general public to identify and further support vulnerable individuals or populations who may benefit from a social prescribing referral.

Practice pharmacists can also identify people who would benefit from a social prescribing referral as part of their daily conversations with the patients attending the practice and also when they undertake a more in-depth Structured Medication Review.

Supporting overprescribing review recommendations

The national overprescribing review report talks about a healthcare culture that favours medicines over alternatives and in which some patients struggle to be heard. The report knows that shared decision-making with patients; better guidance and support for clinicians; more alternatives to medicines, such as physical and social activities and talking therapies; and more Structured Medication Reviews (SMR) for those with long-term health conditions can help to reduce overprescribing. 

Social prescribing can support the reduction of an over reliance on medicines, and pharmacists in all cares setting have a responsibility around this.

Recommendations

  • All pharmacists should be made aware of social prescribing and the opportunities this presents to support the health and wellbeing of the people they see and interact with. This will also have an impact on prevention, inequalities and social justice and community integration
  • All pharmacists should have access to training on social prescribing to ensure that the referrals they make are appropriate and ultimately lead to benefits for the person they are referring. Generic national training and guidance should be considered, but with the awareness that referrals and eligibility criteria are usually determined locally
  • Pharmacists should be encouraged and supported to proactively reach out to their local social prescribing service to build up a relationship and gain an understanding on who would be eligible to refer. Link workers should be supported to build relationships with pharmacists in their local areas
  • To help foster appropriate cross referrals and MDT working, pharmacists need to understand what other primary care team members can do to support patients, including social prescribing link workers. There also needs to be an understanding of what pharmacists can deliver in the social prescribing arena from others
  • Ensure there are sufficient numbers of SPLWs to provide capacity for referrals from pharmacists working in all care settings, including community pharmacies
  • Assessment of schemes involving pharmacy should be undertaken in order to identify the benefits and outcomes of having pharmacy involved. This should be a joint initiative between pharmacy teams and social prescribing teams to gather evidence of outcomes.