The Royal College of General Practitioners in Scotland says the next Scottish Government must commit to long‑term funding for community link workers in general practice after research found their role in community prescribing and support for vulnerable patients has grown and become more complex.

Through much of 2024, researchers from the Universities of Edinburgh, Glasgow, Bristol, Manchester and Newcastle upon Tyne interviewed patients, healthcare workers and community link workers (CLWs) in Scotland and their equivalent social prescribing link workers in England.

Their findings have just been published in a paper, Embedding social prescribing in primary care in England and Scotland: a qualitative study of experiences, roles, challenges, and sustainability in the Lancet.

The researchers found CLWs were seeing many more patients with highly complex needs, including the social determinants of health in deprived areas, than they did previously – and were managing to build empathic relationships because of their own backgrounds, training, and support.

The team concluded that CLWs were not only helping patients to build confidence and increase their independence but, where CLWs were working as part of primary care teams, they were also “reducing moral distress and possibly reducing workload” for general practitioners.

The paper emphasises that CLWs have an important role in addressing the social determinants of ill health – but found a series of challenges to the role of CLWs including job retention, burnout, variable pay levels, and too few opportunities for career progression.

A year ago, West Dunbartonshire cut funding for 4 in 10 of its CLW posts.

In their report, the researchers express concern ‘the sustainability of this role was threatened by short-term funding, increased service demand, and financial cuts to essential services’.

Seeing vital work at first hand

RCGP Scotland Chair, Dr Chris Provan says long-term investment in CLWs has to be a priority for the next Scottish government:

"As a GP fortunate enough to have a community link worker embedded within my practice, I see at first hand the vital work they do and the genuinely transformational impact they can have on patients’ lives.

"Increasingly, CLWs are supporting patients to address the wider social determinants of health, rather than simply signposting to community groups or wellbeing services.

“This shift is essential. Scotland has the worst health inequalities in Western Europe, and by helping patients navigate and overcome the social factors that affect their health, CLWs play a crucial role in tackling these inequalities.

"Many patients – particularly those living in socioeconomically deprived parts of Scotland – present with complex, overlapping needs that span social determinants of health, physical illness, mental health challenges, and issues such as loneliness and isolation. When CLWs are fully embedded within general practice, they provide invaluable support not only to patients, but also to GPs and the wider practice team in managing this complexity - as evidenced in this study.

"It is deeply concerning that the continuation of CLW services in Scotland is threatened by short-term and unstable funding arrangements,” says Dr Provan.

“This is short-sighted and counterproductive.

“We should be expanding the availability of CLWs in community settings, not putting their future at risk.

"RCGP Scotland is therefore calling on the next Scottish Government to commit to placing a CLW in every GP practice and to provide long-term, sustainable funding. If we are serious about addressing the entrenched health inequalities facing Scotland, CLWs must be recognised not as an optional extra, but as a core part of the solution."

 

Read more: Film series showcases power of link workers; Link workers outlook: sustainability top of agenda; Lack of structure holding back social prescribing

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