Can Social Prescribing Tackle Loneliness?

I’m Kate and I work as a consultant with organisations in the voluntary sector on a range of issues including ageing, health and care. In recent years I’ve done a lot of work on loneliness like working as Director of the Campaign to End Loneliness, writing the final report of the Jo Cox Commission on Loneliness and recently assessing progress on the Government’s Loneliness Strategy on behalf of the Loneliness Action Group.
Loneliness and Social Prescribing
One of the flagship announcements in the Government’s Loneliness Strategy last October was the roll out of social prescribing services across England – with funding from NHS England by 2021 every Primary Care Network (PCN) will have a Link Worker to help people to access support and activities in the community.
This is good news. There is limited evidence around what works in tackling loneliness overall, but what there is suggests that offering individuals who are experiencing or at risk of chronic loneliness one-to-one support is a good way of reducing loneliness. With chronic loneliness being defined as feeling lonely often, it is this support that allows them to reconnect with people in their communities
So why am I worried about the roll out of social prescribing?
Making sure Social Prescribing works for Loneliness
Firstly, ‘social prescribing’ is a very stretchy term and, while diversity of provision is good, we need to ensure that the models that roll out are the ones that work. In good social prescribing services, Link Workers spend time getting to know individuals, giving them time and space to talk about the issues. They recognise that usually there is a complex web of practical and emotional barriers that is getting in the way of social connections – not just a lack of information. They also understand loneliness deeply.
Knowing that loneliness can be surrounded by stigma means you appreciate that asking people if they are lonely won’t always elicit a true response. You also want a Link Worker to understand that people who have been lonely for a long-time struggle more in social situations, so people need support to step out. Link Workers need to recognise the personal nature of loneliness and that different people find meaningful connections in different ways, so our offer must be flexible. For one person a community choir may be the answer, another may need support in plucking up the courage to reach out to an old friend.
By contrast there are ‘social prescribing’ services which I’m pretty certain would be no help to someone who was deeply lonely – where support is strictly time-limited, conversations are driven by check lists, and the ‘offer’ consists of a narrow menu of formal services.
Secondly, it’s not yet clear who will fund the community services and activities to which Link Workers will need to refer people. NHS England are only funding the Link Workers themselves. In some areas there are lots of services and activities available already, and so the biggest challenge for Link Workers will be staying up-to-date with what’s available, but in other areas there are gaps. In these areas Link Workers will inevitably identify demands that cannot be met. In some existing services Link Workers play a community development role, helping people develop their own community responses to need. However, it’s not yet clear whether Link Workers will have capacity to do this if they are also trying to meet needs across a PCN population of 50,000.
Finally, there are real risks of unintended consequences in this programme. Work on loneliness isn’t new, and nor are social-prescribing-type services: community navigators and connectors, mentors, and Local Area Coordinators all work in similar ways – as was demonstrated by the programme of shared learning we undertook with the British Red Cross and Co-op partnership. It’s really important that PCNs build upon existing expertise in their communities, but in the rush we risk existing services being decommissioned in favour of new ones. Communities can’t afford to lose that knowledge.
What needs to happen next

The roll out of social prescribing services could be really good news, but if we want it to work for loneliness then we need to build services with loneliness in mind. At the national level we need to keep focused on the issue providing the guidance and support PCNs need to understand loneliness and how to tackle it. We also need to measure the impact of new schemes on loneliness, otherwise we’ll never know if they’re working.
In communities up and down the country local organisations who are already involved in working with lonely and isolated people need to make their voices heard – especially by their local PCNs and other health leaders as they decide what to do. As we set out in this report, the time to act on this is now.
What are your thoughts on social prescribing? Have health authorities in your area started consulting on new services? Do you believe this sort of community work could benefit you? Let us know in the comments below!
Replies
Thank you for your interesting post.
In my own personal experience I did not realise how loneliness could affect me until 2 weeks ago when I moved to a new property. I have never been one to feel lonely or bored, but I now know that this was because there were always people around me 'if' I wanted any company and so I did have a choice. However, I have now relocated to a remote village where even if I look out my windows I may not see a single person in 2 0r 3 days. Coupled with this, as I am new here I obviously have no idea where or to who I can approach or perhaps turn to for anything, let alone 'company' of any kind. It is also of course always embarrassing to 'ask' anybody whilst also being concerned about placing yourself at risk.
Many disabled people are totally isolated and their only communication with the outside world may be the internet for example or perhaps an occasional carer or periodical hospital trips etc. In my own view, advertising and promotion about Social Prescribing Services, to incorporate the services available is VITAL. There are far too many already existent services which many people have no idea about the existence of, and an already lonely person will also have difficulties in making the initial approach and/or be incapable to due to their physical disabilities etc. There are also many in the caring profession who will not have the ability to identify a persons loneliness, or be able to make a qualified decision or a risk assessment for example... Many people )like myself) will often mask or disguise their loneliness to others whilst suffering in silence due to embarrassment or from thinking it as a sign of weakness.
During the past 3 years many of the services that I require and for a whole variety of issues have ONLY become known to me via seeing posters & notices in Dr's surgeries or by making lots of searches on line in 'the hope' that a certain service is out there somewhere. I cannot imagine many lonely people spending their time doing this. I therefore think that printed material made available to those who have the ability to read it should be provided to the community at large, whilst all those that are seen or visited by paramedics/carers/occupational therapists etc., are made aware of all services available which are applicable, and loneliness is one such thing which can very much indeed affect anybody at anytime whether or not you are disabled.
I have a communication disability, which means that anyone trying to help me work around my communication disability to overcome my loneliness has to be trained regarding the complex nature of my disability, and especially the verbal communication problems i have everyday.
I have Auditory Processing Disorder, my brain having problesm processing and understanding the sounds my ears hear, which includes speech. Currently in the UK the main problem is the professional negligence of most UK Audiologists who fail to even understand the audiology of Auditory Processing Disorders let alone explain these complex issues to any multi discipline support medical professionals or support workers.
So you would have to have the 3 UK audiology professional bodies radically improve the minimum qualification requirements to include all aspects of audiology including the 4 types of Auditory Processing Disorder.
I am house bound as I need to avoid the lack of awareness of my communication disability causes by this professional negligence by UK audiologists, and the recommended multi discipline support team which should include psychologists, and speech and language therapists. They the major cause of the loneliness pure disability discrimination.
I think making friends is a good idea. It is important for our wellbeing. In my local area, there is a established carers network that supports carers. Additionally there are several good care homes and independent care companies for disabled folk all over Surrey. This is a step in the right direction. It makes me proud seriously.
But, I still have had issues trying to find out if there are activities for physically impaired kids however. It seems that many care providers and care homes automatically are created for those with learning difficulties/disabilities. This is not true disability inclusion. I have struggled to find information on clubs that are solely for those with physical impairments. Why is this? There is work still to be done. I don't want my son to be left out for no reason. Isn't it crazy?
I am thinking of setting up my own care company for those with mobility issues. There seems to be a gap in the market that could be filled. I think it is a real shame. Who is with me on this issue? It is a tad disturbing and a little frustrating to me. One fully capable group is being left out when they should not be.
Not many able bodied people can fully appreciate some of the challenges that we face. This doesn't necessarily mean that they don't comprehend, but I am sure that somebody with a certain disability understands more and this in turn can assist others with the same difficulties etc... after all, many people do exactly that within our online community here on SCOPE and our help to others with the same challenges (including loneliness) is invaluable to each other… Just imagine if this was one-to-one in person, for people who are not members but are perhaps within our local communities?
Such people would also be helping themselves and would feel more confident and less isolated too.
There will always be disabled people who perhaps don't want to mix with people of their own disability or illness, but there are many who just need a good listening ear and an understanding voice, and this can make so much difference at times, with one supporting the other and vice versa...
The disabled, caring and supporting the disabled in person, would be a milestone in every community, as there are many communities where the able bodied don't truly support or understand us at all. They only 'think' that they do.
So yes those of us who have some type of disability may be more empathetic to others who have the same or similar disabilities which we may be able to understand, and probably better than those who have no disability as all.
It is true that most 'groups' establish themselves without the disabled being in mind, and are usually formed by likeminded people with a keen interest in their particular field. Of course many of these same groups will perhaps allow you to join them, but they are not disabled friendly in terms of access or inclusion. I don't know what the answer is without the use of a Magic Wand, and the costs involved with travelling to some groups and/or using their facilities is also quite often the stumbling block too...
I must say though, that since I joined my local community group on Facebook, it has offered me as much information about what's on etc. and the facilities which are available in my immediate area. The people have also been very helpful as best they can and/or have pointed me in the right direction.
By being referred to a certain place or an organization via my GP for example, only reminds me again of my illness & disabilities. I believe that our local Councils should do far more by making everybody aware what is on offer. After all, they will be totally aware of such places under their catchment areas.
Some years ago I volunteered helping a local walk group, as you mentioned they were not really willing to help and understand those who had any real issues and problems with exercise, And eventually due to my communication problems I felt isolated from both those who ran the group, and those who attended on a regular basis.
Added to which the majority of so called medical professionals who should be participating as part of the multi-disciple support team only want to deny that my disability exists in order to hide their ignorance and incompetence. This the reason I have been using international research papers to explain mine an other peoples various disabilities.
Go to your g.p. is just as out of the question.
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Like others on here have mentioned for me I find larger groups overwhelming and I have had some success in smaller groups of 4 or 5 people. This takes me time to get to know and feel safe in the group and depends on lots of things for me to stay. But I know from experience that much success can be achieved from giving it a go. I try things once and then decide whether to stay or go.
This is after a long period of time working up to the trying part.
I rely on on my son a lot to support me when I am going out and about outside as it’s one of my issues. I often wonder what other people do when they don’t have someone close to support them and how much harder that must be? I also know this won’t always be the case for me when my son isn’t around and wonder what I will do when that happens? In an ideal world we would have “buddies” to support us with getting around as opposed to paid professionals like support workers and the like. Personally I don’t like the idea of that and I can’t see me qualifying anyway.
What are other peoples experiences of getting help to get around in your local area where you may have m h issues like social anxiety, agoraphobia or other issues please?
Thanks for the article.
There is too much stigma attached to loneliness. People fear admitting that they’re lonely. There’s not enough done to combat loneliness. People don’t talk enough about it. And I know that there are campaigns going on. But they’re not working.
I believe that some people feel a deep loneliness from within. No matter how many people they be around and for how many hours per day they’re still going to feel a deep inner loneliness. This, I believe needs to be addressed by therapy. Most don’t approach GP for this and when GP is approached, the wait times are ridiculously long. Not enough resources. So many people suffering. Some people may get helped in this way. Who knows?
People have other barriers to seeking the company of others, I know... anxiety, panic attacks, other conditions too. It’s so hard.
I know it can be hard sometimes
I am always here and you're always welcome to message me or post on my wall if you'd like a chat Take care xxx
For the Jo Cox resource centre near you, it should be shut down. Ridiculous they’ve had the funding to provide what she wanted and have done nothing with it. You have the evidence to do it, sent it to the charity commission/their funders.
I completely agree about the stigma noone talks about it
I think lonliness has now become an accepted part of life. People have replaced connection with social media and we have forgotten how to genuinely be there and support each other. This culture of online dating isn;t helping either - the idea you let someone into your home after seeing their picture online maddens me. We let strangers into our home to be intimate with us, add strangers on facebook and never see our friends and family they become strangers to us because of an increasingly high cost of living, less wages and less time for everyone. This is a direct result of our structure of a society and how it’s worked out.
I agree with the deep lonliness too - therapy is good and there are some wonderful therapists out there. I would always encourage someone going through a life change or who may feel lonley and needs to start somewhere to start with therapy
In terms of time I think a lot of people are working days, nights, weekends and not even making ends meet. So you’re either disabled stuck at home sick can’t get out or you’re working your butt off to get enough money to meet the rent and it’s still not enough and you’re still not getting enough time for rest or sleep. I think having a bad economy has made us all bad friends. We need to address the problems going on before anything will get better
Theres no community activities anymore or a severe lack of them because the working have no time for them and the disabled can't afford to fund them and not fit to run or manage them alwaysI agree about tribes too. I think people have forgotten this and forget how to be a living breathing person, because of pressure to look a certain way and survive rather than be a human being. The problem starts with us all and ends with us all
Sorry to hear this @Jean Eveleigh, this must have been very frustrating!
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