Health & Care Systems
Screening, referral, and where connection fits in a care pathway.
Guidance 26
Running a Loneliness Group by Phone, Video, or in Person: What the Trial Evidence Actually Supports
A look at how structured remote delivery has outperformed in-person befriending in the strongest available trials, and what that does and does not mean for a social prescribing service choosing a modality.
Who Owns the Referral After You Make It
A practice note on the operational failure point in health-and-community partnerships for loneliness: what happens after the referral, and who is accountable for it.
Measuring the Handoff, Not Just the Outcome
How to evaluate a social prescribing referral pathway when the thing most likely to fail is the handoff between clinician and community link worker — not the activity at the end of it.
How to Structure Roles Inside a Social Prescribing Group So It Doesn't Collapse by Week Four
A procedure for assigning roles inside a referral-based social group — host, anchor, and connector — so participation survives past the first few sessions.
When a Funder Asks for Evidence Your Programme Cannot Produce
A practice note for when a commissioner or funder wants your loneliness or social prescribing programme to demonstrate outcomes the intervention literature has not yet established. What to renegotiate, and how.
How to Report Attrition Without Burying It or Weaponising It
A practice note on presenting dropout data in social prescribing and connection programme reports so it strengthens your case to funders rather than undermining it.
Who Doesn't Walk Through Your Door, and Why
Most social prescribing referrals reach people who already have some capacity to seek help. A practice note on redesigning recruitment so it finds the people who won't.
When a Commissioner Asks for Loneliness Outcomes You Cannot Promise
A funder or commissioner wants a defined reduction in loneliness or isolation from a social prescribing referral pathway. Here is how to respond when the evidence does not support that ask, without either overselling or refusing the work.
AARP's New Loneliness Data Is Another Argument Against Generic Referrals
AARP's 2025 follow-up survey shows loneliness among adults 45-plus rising, not falling. The operational fix isn't more referrals to social activities — it's matching the intervention to which kind of disconnection someone actually has.
What the WHO Report Changes for Health and Community Partnerships
The WHO Commission on Social Connection has given health systems a mandate to treat connection as a clinical concern. The bottleneck is not referral volume — it is whether community organisations can absorb it. Six decisions to make before you sign anything.
The First Four Weeks: Sequencing a Health System's Social Connection Response
A week-by-week sequence for health and care teams starting to screen for and act on social isolation and loneliness, built around where these programmes actually fail first.
How to Evaluate a Social Connection Referral Pathway Without a Research Team
A practical evaluation design for social prescribing and connection referral programmes that a link worker or programme manager can actually run, using outcomes the data already supports.
How to Report Attrition Without Burying It
A practice note on reporting who drops out of a social connection programme, and why the honest version of that number strengthens a funding case rather than weakening it.
Why Social Prescribing Referrals Fail by Week Four
The most common social prescribing pathway is a single referral to a community group with no follow-up. Here is why that design fails predictably, and what a sequenced pathway looks like instead.
Give People a Job: Why Roles Beat Icebreakers in Social Prescribing Groups
The evidence on structured versus unstructured group activity suggests that assigning members a task or role does more for loneliness outcomes than open-ended mingling. A practice note for anyone designing a referred group.
When the Evidence Base Doesn't Support What You're Being Asked to Fund
A practice note for programme managers asked to prove a social connection intervention reduces isolation, prevents disease, or cuts costs, when the underlying trial evidence cannot support that claim.
The First Four Weeks: A Sequencing Framework for Social Prescribing Referrals
What a link worker or programme manager should actually do, week by week, between referral and the point most people drop out — and why the order of activities matters more than the activities themselves.
Safeguarding in Social Prescribing: How Programmes Have Approached the Risk
Social prescribing puts vulnerable people into unsupervised group settings run by voluntary and community organisations. Here is how the sector has approached the safeguarding gap this creates.
Social Prescribing: What to Sequence in the First Four Weeks
A practice note for social prescribing link workers and commissioners on ordering the first month of a referral, so structure and purpose come before contact for its own sake.
Why Reach Numbers and Outcome Numbers Answer Different Questions
A social prescribing programme can hit its referral targets and still fail the people who need it most. What tracking reach alongside outcomes actually reveals, and why one without the other misleads funders.
What to Fix and What to Flex When You Scale a Connection Programme
A group that works at one site is about to be commissioned across thirty. Guidance on writing a fidelity specification before the contract does it for you, and the funding mechanic that quietly destroys dose.
Choosing a Venue That Doesn't Quietly Kill Attendance
A sequenced checklist for picking the room, the time, and the route that determine whether people referred to a group actually show up twice.
Reporting Attrition Honestly in Social Prescribing Evaluations
Dropout data in connection programmes is usually buried, not analysed. A practical approach to counting, categorising, and reporting attrition so a funder can trust the outcome numbers that remain.
Reach and Outcome Are Different Numbers: A Framework for Measuring Both
A framework for social prescribing and connection programmes that separates who you reached from what changed for them, and explains why funders need both numbers to mean anything.
Social Prescribing's First Four Weeks: What the Sequencing Looks Like
A look at how social prescribing link worker services structure the first month after referral, and where the published evidence says that sequence tends to break down.
The Week Four Problem in Social Prescribing
Attendance in most social connection programmes does not decline gradually. It falls off a cliff at a specific point. This note is about designing for that point rather than being surprised by it.