Defining social prescribing link worker practice in Europe: an international Delphi consensus study of core functions, training needs and implementation conditions.

Abstract

To develop expert consensus on best practice approaches to social prescribing (SP) in European primary care, with a focus on the roles, competencies and implementation conditions for social prescribing link workers (SPLWs). A three-round Delphi study conducted online. Round 1 used open-ended questions to map current practice and inform statement development; Round 2 rated 52 statements on a 5-point Likert scale with an a priori approval threshold of ≥80% agreement (agree/strongly agree); Round 3 rerated 19 statements using approval (≥80% agree/strongly agree) and rejection (≥80% disagree/strongly disagree) thresholds. Virtual (online survey platform). An international, multidisciplinary expert panel recruited via relevant SP networks and targeted invitations, including researchers, healthcare professionals, link workers and implementation stakeholders in accordance with the published study protocol. Round 1 was completed by 75/85 invited panellists (88%). In Round 2, 57/75 (76%) rated 52 statements across six domains; 19/52 met the ≥80% agreement threshold, with strongest consensus for core SPLW functions (navigation, advocacy, follow-up and documentation) and for support needs (mandatory communication/navigation training and supervision). Round 3 was completed by 57/57 (100%) and approved 13/19 rerated statements, extending consensus to include data collection with appropriate safeguards, optional accompaniment to community activities, limited first-step support for urgent social problems, context-sensitive funding principles, a cofunded employment model, multiple access routes (including telephone/in-person/online), self-referral and secondary-care referral, and the use of digital tools as complements rather than substitutes for relational support. Across three Delphi rounds, the panel converged on actionable, consensus-based recommendations for SPLW practice and for accessible, context-adaptable implementation.