UK 
United States
By Tracey Ward, Head of Business Development & Marketing at Generali UK Employee Benefits
The UK government sees a strong place for social prescribing, also known as community referral, as part of its plans to help the long-term sick get back to, or stay in, work. And rightly so. It’s an aspect to early intervention – preventing absences becoming long-term issues – that Vocational Rehabilitation has long-considered as part of its person-centred, or biopsychosocial, approach.
However, unless an employer has access to Vocational Rehabilitation – either through a Group Income Protection arrangement, or standalone – it’s easy to overlook the social aspect, and/or to dismiss it as the responsibility of the individual.
But, considering the benefits to business of a sustainable approach to return to work – and the role of social in that – it’s arguably the responsibility of the employer to help facilitate such opportunities too.
So, what is social prescribing?
While the official label of ‘social prescribing’ is still relatively new, the underlying concept seems as old as the dawn of time. Put very simply, involvement with other people in your local community – anything from having a coffee with a neighbour, volunteering and befriending to gardening, exercise and crafts – makes you feel good.
That concept is now being applied to back to work support, because it’s generally recognised that social prescribing doesn’t just make you feel good, it can actually help with social isolation and loneliness. Such issues are all too common where long-term absence is concerned.
It’s worth pointing out here that social isolation and loneliness aren’t the same thing.
Social isolation is an objective lack of social contacts. Whereas, with loneliness, you might have social contacts, but still experience loneliness.
Risk factors for loneliness include being: widowed, single, a carer, unemployed, living alone, having a long-term health condition or disability and, perhaps surprisingly, being aged between 16 and 24 years old.
There’s strong evidence to suggest that loneliness is a strong predictor of poor mental health. It also impacts physical health, affecting sleep quality, for example.
Meanwhile, on social isolation, research shows that where it’s a persistent problem, it’s linked to cardiovascular issues, mental health disorders and increased mortality rates.
The biopsychosocial model, which was first conceptualised in 1977 and commonly used by Vocational Rehabilitation professionals, encourages a focus on the physical, psychological and social factors.
And, more recently, the UK government has helped shine a light on the benefits of social factors.
As part of NHS England’s personalised care plan, social prescribing link workers started to be introduced into GP surgeries from 2020 onwards.
And, from this April, the Department for Work & Pensions’ new WorkWell pilot will begin. Designed as part of a series of initiatives to help the long-term sick stay in or return to work, the WorkWell pilot will see referrals being made to social prescribers, amongst other community-based services, from life coaches and running clubs to community groups.
What might employer support look like in practice?
First things first, listen to employees.
“Everyone has a different social metre and it’s important to recognise that,” says Dr Julie Denning, Chartered Health Psychologist and Managing Director of Working To Wellbeing, one of our valued early intervention and rehabilitation partners. Julie is also Chair of the Vocational Rehabilitation Association.
“Don’t make assumptions. Take extraversion and introversion for example. There’s often a big assumption that extroversion is the preferred personality trait. But assuming extroverted activities suit all is a big mistake. So, don’t have enforced social activities, for example, because it might backfire and end up causing stress as opposed to relieving stress.”
Most organisations encourage employees to participate in volunteering. Indeed, a spot poll of audience attendees during our recent webinar with Julie on the topic of social prescribing, found this was the top social activity on offer (78%).*
Next was employee representative groups and networks (67%), then in-house clubs and societies (56%) and, lastly, community based clubs and social activities (11%).
“The latter could represent an avenue worth exploring,” says Julie. “Especially for home or hybrid workers who often live a long way from the actual place of work, rendering onsite activities difficult.
“Considering the number of people home or hybrid working, perhaps there’s an argument for giving people the official flexibility in their day to make connections in their local communities – anything from music and singing clubs to crafts and fitness.”
All of this – the social needs of individuals – needs to be taken into account as part of early intervention and rehabilitation, adds Kay Needle, early intervention and rehabilitation expert at Generali UK Employee Benefits; also speaking as part of our recent webinar.*
A case in point: the importance of a person-centred approach
To help illustrate this in practice, Kay uses the hypothetical example of someone absent from work because of stress and a diagnosis of hypertension. This individual gets referred by his employer to Generali for early intervention support, as part of his Group Income Protection cover.
Kay says: “Through discussion with the individual, our rehabilitation partner finds out that he suffered a knee injury 18 months prior to the stress and hypertension. They also discover that he was a keen runner and member of a local running club. This represented his main social outlet. He felt that running was not only good for his physical health but also for his emotional wellbeing.
“As a result of the knee injury, he stopped going to the club. So, he’d withdrawn from his main social support. He’s also not sleeping well because of the pain, but also probably because of reduced physical exercise. He’s a little irritable to live with and there are tensions with his partner at home. That’s all started to build and spill over into the workplace, contributing to a few performance concerns prior to his diagnosis of hypertension and subsequent absence.
“When you drill down into it though, what we’ve actually got here is not someone with a primary issue of stress and hypertension. It’s someone who had a knee injury. If he’d had a conversation with his line manager early on, that could have been addressed with physiotherapy via his Group Income Protection cover. Acting early might have ensured he got back to running and back to his social support, as part of the club.
“Vocational rehabilitation could have also advised him at that early stage – and while having physio – that he could still go to the club. Just be on the sidelines and chat with friends. Just being involved – being social - would have benefitted his emotional wellbeing and helped prevent that downward spiral.”
*To access a recording of the webinar, entitled ‘Social prescribing and its role in back to work support’, please email [email protected].
Disclaimer:
All information contained herein represents the views and opinions of the author as at the date of writing and is provided for general information only. Nothing herein constitutes or is intended to constitute financial or other form of advice and no individual should rely upon the information provided in making a specific investment decision without first seeking independent professional advice.
