Best practice approaches to social prescribing in European Primary Care: A Delphi protocol focused on link workers

Abstract

Introduction: Social prescribing (SP) is an innovative model that connects individuals to non-clinical community resources. However, its uptake and evaluation have been hindered by inconsistent role definitions for key stakeholders. Although recent studies have refined SP definitions, outside the UK, the responsibilities, educational backgrounds and training requirements of social prescribing link workers (SPLWs) remain poorly defined. Additionally, it is essential to identify which patient populations will benefit most from SP, establish specific methodologies, and standardize assessment tools and referral pathways.

Material and methods: We will employ a 3-round Delphi protocol with an international expert panel to establish consensus on SP definitions. Approximately 60 participants from diverse disciplines and regions will be recruited to complete multiple survey rounds, providing insights into the roles of SPLWs, beneficiary populations, methodologies, and assessment tools. Consensus will be defined as at least 80% agreement on a 5-point Likert scale. Data collection and analysis will follow rigorous protocols to ensure validity, reliability and transparency, in accordance with the Guidance on Conducting and REporting DElphi Studies (CREDES) guidelines.

Objectives: The aim of this research is to unify the fragmented understanding of SP and the role of SPLWs, thereby establishing a foundation for integrating SPLWs into healthcare systems where appropriate. The Delphi technique offers key strengths - namely, participant anonymity and structured iterative feedback - to enable robust consensus building. While we acknowledge limitations such as potential participant attrition and the resource-intensive nature of the methodology, these will be mitigated through targeted engagement strategies and strict adherence to established best practices.

Conclusion: This study addresses critical gaps in SP engagement, conceptual understanding and implementation. The anticipated outcomes will reinforce SP's role in community-based, integrated care to reduce health inequalities and foster social cohesion across Europe and beyond. Ultimately, this work aims to enhance the uptake and adoption of SP in primary care.

Keywords: community health services; integrated care; link workers; primary health care; social prescribing.