[AVBC 2025] Improving Access to Community Activities for Polyclinic Patients via Social Prescribing
Care Continuum
Appropriate & Value-based Care Conference
National Healthcare Group
11 December 2025
The aim is to increase the number of patients participating in community activities through social prescribing and Link. Improvements in physical activity may translate to improved mental and physical health outcomes, resulting in reduced overall.
Year Submitted: 2025
Published Date: 11 December 2025
Tags: Care Continuum, Preventive Care, Community Health, Intermediate and Long Term Care ＆ Community Care, Social Care, Population Health, Mental Health, Physical Health
About this Content
Aims
The aim is to increase the number of patients participating in community activities through social prescribing and Link Workers.
Background
Social prescribing connects patients to non-clinical services in the community, addressing social determinants of health to improve outcomes. Healthier Singapore emphasized its importance, but there is limited manpower and consultation time for clinical care and social prescribing.
Methods
Social prescribing was delegated to Link Workers who use the transtheoretical model of change to promote behavioral change, recommend, and link patients with suitable community activities. Participants were identified by the healthcare team and referred to the Link Worker.
Results
From November 2023 to April 2025, 1,200 patients were referred to the Link Worker, with 325 (27%) showing interest in the recommended activities. Patients showed an average improvement in physical activity level per week by 57.1 minutes, and 71% continued with other community activities. 93% were satisfied with the recommendations, and 100% would recommend Link Workers to others.
Conclusion
Improvements in physical activity may translate to improved mental and physical health outcomes, resulting in reduced overall healthcare costs. Further evaluations are underway to measure improvements in patient activation and clinical outcomes.
Lessons Learnt
Delegating social prescribing to Link Workers was successful in helping patients take the first step into community activities, contributing to maintaining quality of life, health, and physical function, and reducing falls among seniors.
Keywords
Social prescribing, Community activities, Link Worker, Patient engagement
Innovators' Details
Innovators' Details
Healthcare Cluster(s) | National Healthcare Group |
Organization(s) Involved | National Healthcare Group Polyclinics |
Platform(s) | Appropriate & Value-based Care Conference |
Healthcare Professional Group(s) | Allied Health |
Applicable Specialty or Discipline | Medical Social Workers |
Project Lead(s) | Valerie Teo Hui Ying |
Project Member(s) | Valerie Teo Hui Ying |
Connect with this contributor!
Valerie Teo Hui Ying - valerie.hy.teo@nhghealth.com.sg