ORIGINAL RESEARCH article
Front. Public Health
Sec. Public Health Policy
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1645353
This article is part of the Research TopicSocial Prescribing: Advancing Evidence-Based Public Health PoliciesView all 3 articles
Third Sector Perspectives on Community Link Worker Referrals in Social Prescribing: A Realist Analysis
Provisionally accepted
- 1School of Health Sciences, Queen Margaret University, Musselburgh, United Kingdom
- 2Edinburgh Health and Social Care Partnership, Edinburgh, United Kingdom
- 3Edinburgh Napier University, Edinburgh, United Kingdom
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Introduction Community Link Workers (CLWs), also known as social prescribing link workers, connect individuals to community support, much of which is provided by third-sector organisations (TSOs). TSOs are common referral destinations for CLWs, yet the relationships between CLWs and TSOs remain under-explored. Method This realist study investigated TSOs’ perceptions of link working, focusing on referral and collaboration dynamics. Conducted across 22 TSOs in Scotland, it involved in-depth interviews with TSO staff and consultations with CLWs and managers, analysing data via realist heuristics to identify contexts, mechanisms, and outcomes. Results Targeted referrals by experienced CLWs, with follow-up, and strong TSO-CLW relationships, improved client health, wellbeing, and independence while reducing reliance on statutory services. These processes fostered professionals’ trust, satisfaction, and innovation, creating a positive feedback loop. Conversely, inconsistent referrals, such as over-referral or scattergun approaches, compounded by resource constraints and perceptions of inequitable partnerships, led to suboptimal client outcomes, dissatisfaction, and weakened collaboration. Important contexts included extreme resource pressures, varying CLW expertise, and perceptions of power imbalances. Discussion Effective social prescribing needs sustained TSO-CLW collaboration, supported by third-sector investment and tools for equitable partnerships. Rather than a referral process, social prescribing should be envisioned as a community of practice, defined by relationships, a common purpose and shared responsibility for challenges and solutions. Future models should prioritise strengthening statutory and third-sector trust and collaboration.
Keywords: HA -Writing, editing, Conceptualisation, methodology DM -Writing, methodology, funding acquisition AL -Critical review, editing AC -Conceptualisation, Critical review
Received: 11 Jun 2025; Accepted: 15 Sep 2025.
Copyright: © 2025 Allbutt, Maciver, Leitch, Crandles and Irvine Fitzpatrick. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Donald Maciver, dmaciver@qmu.ac.uk
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