Social prescribing in primary care for people living with dementia: a qualitative exploration of different roles and services in England

Pick et al. BMC Primary Care (2025) 26:346 https://doi.org/10.1186/s12875-025-03011-9 BMC Primary Care Open Access RESEARCH Social prescribing in primary care for people living with dementia: a qualitative exploration of different roles and services in England Aimee Pick1* , Emma Wolverson2,3 , Jane Cross4 , Chris Fox5 , Esme Moniz-Cook6 , Joanne Reeve6 , Kritika Samsi7 , Louise Robinson1 and SPLENDID Collaboration Abstract Background Dementia is a global public health challenge with the number of people living with the condition rapidly rising. Social prescribing in primary care has emerged as a person-centred approach connecting individuals with community support. It is increasingly explored for its potential to support people with complex needs, yet its role in dementia care remains uncertain. This study aimed to explore current provision of social prescribing for people living with dementia across England, identifying relevant aspects for dementia care, with particular focus on generic and specialist services. Methods Semi-structured interviews were conducted with regional leads of social prescribing services and social prescribing link workers (SPLWs) across England. Data were analysed using template analysis to identify key themes. Results Twenty-two participants were interviewed: ten social prescribing regional leads, four generic SPLWs commissioned to work with people aged > 18 years, and eight SPLWs working exclusively or partly with a specific adult population. Four themes were identified: family carer engagement key to supporting people living with dementia; service rather than person-centred care; the dominance of dementia in influencing support; and strategies for success: dementia centred social prescribing. Participants identified the central role of family carers in facilitating access to social prescribing, highlighting that carer support was often essential. Generic social prescribing frequently followed a ‘service-led’ approach, with service constraints negatively influencing interactions. Dementia was often perceived as the dominant support need, potentially marginalising individuals within broader social prescribing services. Despite these challenges, participants with more role flexibility, and/or more experience of dementia, demonstrated a range of successful strategies, illustrating the potential of social prescribing for people living with dementia. Conclusion SPLWs perceive that social prescribing has potential to play a key role in support for people living with dementia and family carers. While its core principles align well with dementia care, our findings suggest a social *Correspondence: Aimee Pick Full list of author information is available at the end of the article © The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. Pick et al. BMC Primary Care (2025) 26:346 Page 2 of 13 prescribing model more tailored to the needs of people living with dementia, or additional dementia-specific training for generic SPLWs, may prove more effective. Further research is needed to assess the impact of these approaches, especially for people living with dementia without access to family carers. Keywords Social prescribing, Dementia, Link worker, Primary care Introduction Dementia is a global public health issue as ageing societies lead to increasing prevalence of the condition worldwide [1]. In England, there were 944,000 people living with dementia in 2022; predicted to be over 1.5 million by 2040 [2]. The complexities associated with dementia include the effects of cognitive impairment, the impact of age-related health co-morbidities, social exclusion as well as economic demands on people living with dementia, their families and health and social care systems [3–8]. The social health paradigm as applied to dementia care is a growing area of research and knowledge [9, 10]. Within this paradigm, efforts to counteract stigma and ‘othering’ among those recently diagnosed by facilitating social opportunities may yield positive outcomes in preventing some of the well-known aspects of social isolation in people living with dementia [8, 11, 12]. Social prescribing is a non-pharmacological approach defined as "a means for trusted individuals in clinical and community settings to identify a person who has non-medical, health-related social needs and to subsequently connect them to nonclinical supports and services within the community by co-producing a social prescription,” (p8) [13]. Social prescribing aims to improve health and wellbeing outcomes and reduce burden on health services [14, 15]. In England, it is a key component of the National Health Service (NHS) augmented by a financial commitment that by 2023, every primary care General Practice (GP) had access to a social prescribing link worker (SPLW) [16]. In dementia, social prescribing’s focus on person-centred care aligns with primary care goals and policy initiatives to promote functional capabilities and independence for people living with dementia in the community [17]. The emphasis on valuing the person, upholding personhood, meeting psychological and social needs, adopting the person’s perspective and ensuring a supportive social environment for people living with dementia is fundamental to social prescribing, thus potentially fulfilling a support need often not currently met [18] and increasingly utilised as part of holistic support packages for people with complex needs [19]. The effectiveness of social prescribing is difficult to quantify [20]. Benefits have been shown for people struggling with social isolation, mental health difficulties, and multiple health conditions [21–23], all issues impacting people living with dementia [24]. Some early evaluations showed positive effects on reducing GP and emergency department visits [25]. People living with dementia have benefited from a range of community activities, suggesting a social prescribing approach might help with the ‘non-medical’ aspects of living with dementia [26–28]. However, access to social prescribing services varies considerably in duration, intensity, and type of support offered, from telephone only contact and signp (...truncated)