Canadian Social Prescribing Pathway.pdf

The Social Prescribing Pathway in Canada consists of five stages: Enter, Connect, Attend, Follow-up, and Exit. Individuals enter the pathway with unique needs, strengths, and interests, and may discover social prescribing through primary care, social & community services, or self-referral. They connect with a prescribed support or service that meets their needs, which can include various activities addressing different factors of wellbeing.

Individuals may require guided support, such as transportation or advocacy, to overcome barriers accessing resources. Exit procedures vary depending on the program and individual, and occur when the individual has received the support they need or decides to discontinue participation.

Key actors and stakeholders involved in the pathway include Social Workers, Link Workers, Systems Navigators, Community Connectors, Patient Champions, Volunteers, Program Coordinators, and Resource Coordinators. A Link Worker is a community connector who builds relationships, assesses client needs, and provides warm hand-offs and support.

The Link Worker Pathway provides continuous support, and individuals may engage with an initial point of contact to identify their needs, strengths, and interests. They may be referred to a service or support that improves their wellbeing, or to another source of social prescribing.

The pathway involves assessments and informal conversations to understand individual needs, and a personalised Care Plan may be co-created to enable a longer-term spectrum of support. Follow-up is used to assess the fit of the prescription, redefine goals, and identify any barriers to access.

Healthcare providers, social workers, and community connectors play a crucial role in the pathway, and outcomes may be tracked to evaluate individual and initiative-wide success. The pathway may be integrated with Electronic Medical Records to facilitate further check-ins by a physician.