P14-2 Exploring the potential harms of social prescribing using dark logic. A global umbrella review

Background Social prescribing has provided a lifeline to people, capturing the importance of quality support offered via community connections. It has not been exempt from difficulties, resulting in low-quality evidence on effectiveness, in part due to high drop-out rates and lack of controls. While these have been the focus of recent research, less attention has been paid to the safety implications of social prescribing. This review aims to understand safety implications of social prescribing interventions and to build a dark logic model of how harms are produced.

Methods Using review of review methodology, we searched nine databases to June 2024. Data were extracted from included studies using the Typology of Harms Framework, which includes five categories of harms associated with interventions: physical, psychological, group/social, equity and opportunity harms.

Results Sixteen reviews were included, reporting on social prescribing research including a link worker. Of the identified harms, we found that opportunity harms (harm related to the cost, inappropriate or ineffective interventions) were most reported. There was also evidence extracted to suggest plausible psychological, equity (impact caused by inequity in provision, delivery, or access), and group/social harms (impact that overly or inadvertently excludes a person).

Conclusion Social prescribing, as with any delivery of care, has the potential to cause harm. We identified a range of potential harms (psychological, group/social, equity, or opportunity harm) from social prescribing, however, it is unlikely to be an exhaustive list. We provide two clear outcomes: 1) the need for robust design of social prescribing research, including collection of data on the incidence and prevalence of harms, 2) recognition of the potential for harm from social prescribing and to address these where practicable.