Demo

Social Prescribing Link Worker

TrueNorth Community Services
Fremont, MI Full Time
POSTED ON 4/16/2025
AVAILABLE BEFORE 6/16/2025

SUMMARY

Social prescribing empowers people to take control of their health and well-being through referral to non-clinical social prescribing link workers. They give people time to focus on ‘what matters to me’ and take a holistic approach to an individual’s health and well-being.

Social prescribing link workers:

  • Take a whole population approach, working with a range of people who may benefit

from social prescribing, including people who are lonely, have complex social needs,

low level mental health needs and long-term conditions

  • Help people identify issues that affect their health & well-being, and co-produce a

simple personalized care and support plan

  • Support people by connecting them to non-medical, community-based activities,

groups and services that meet their practical, social and emotional needs, including

specialist advice services, arts and culture, belonging, physical activity, and/or nature

and green-based activities

  • Use coaching and motivational interviewing techniques to support people to take

control of their own health and well-being

  • Support development of accessible and sustainable community offerings by working

in partnership with volunteer organizations, local authorities and others to identify

gaps in provision, and take a community development approach to enabling growth

in community activities and groups

ESSENTIAL DUTIES AND RESPONSIBILITIES:

  • Take referrals from healthcare providers and from a wide range of agencies,

including pharmacies, health and other care multi-disciplinary teams, emergency

services, legal and welfare advice services, volunteer organizations, and through self-

referrals (list not exhaustive)

  • Provide personalized support to individuals, their families and carers to access

community-based activities and support that can help them to take control of their

health and well-being through co-producing a simple personalized care and support

plan; ENGAGE! will introduce people to appropriate activities, groups and services

as described above

  • Work with appropriate supervision to manage and prioritize your own caseload, in

accordance with needs, priorities and support required by individuals and refer

people back to other health professionals/agencies, as appropriate or necessary

  • Build ongoing relationships with local organizations, community activities and

support services to increase knowledge of the community support offerings, and

work collaboratively to develop effective partnerships, work to support the

community offerings to be sustainable, identifying gaps in provision, and nurture

community assets

  • Increase and strengthen the capacity of the community, enabling local volunteer

organizations and community groups to both receive referrals and to make

referrals to social prescribing link workers

  • Educate non-clinical and clinical staff on the community support offerings, how and

when participants can access it, and the value of non-medical community-based

interventions; this may include verbal or written advice and guidance

Key Tasks:

Referrals

  • Promote social prescribing as a holistic approach across the county by attending

relevant community meetings to build relationships and develop links with local

agencies

  • Proactively develop strong links with local agencies to encourage appropriate

referrals

  • Provide referral agencies with regular updates about social prescribing, including

training for their staff and how to access information to encourage appropriate

referrals

  • Seek regular feedback about the quality of service and impact of social prescribing

on referral agencies

  • Proactively encourage equitable participation in social prescribing through taking

self-referrals and connecting with diverse local communities through a range of

methods, particularly communities

Provide personalized support

  • Meet people on a one-to-one basis, making home visits and visits to community

organizations where appropriate and within organizations’ policies and procedures.

Job Description Community Connections Link Worker

  • Use appropriate judgement to ascertain the number and length of sessions

required, responding to the needs of the individual and their circumstances

  • Give people time to tell their stories and focus on the question, “what matters to

me?”

  • Build trust and respect with the person, providing non-judgemental and non-

discriminatory support, taking a strength-based approach that focuses on a

person’s assets

  • Work with the person, their families and carers and consider how they can all be

supported through social prescribing

  • Help people identify the wider issues that impact their health and well-being, such

as debt, poor housing, being unemployed, loneliness and caring responsibilities

  • Work with individuals to co-produce a simple personalized support plan to address

the person’s health and well-being needs – based on the person’s priorities,

interests, values, cultural and religious/faith needs and motivations

  • Provide information on the groups, activities and services they are being connected

to

  • Provide information on what the person can do for themselves to improve their

health and well-being

  • Physically introduce people to appropriate community groups and activities, peer

support groups, ensuring they are comfortable, feel valued and respected

  • Provide follow up support to the person to ensure they are happy, able to engage,

feel included and that they are receiving good support

  • Help people maintain or regain independence through living skills, adaptations,

enablement approaches and simple safeguards

Supporting the community offerings

  • Develop supportive relationships with local volunteer organizations,

community groups and statutory services, to understand their offerings and

make timely, appropriate and supported referrals

  • Create strong links with local agencies to utilize existing networks and build

on existing provisions

  • Work collectively with all local partners to ensure community groups are

accessible and sustainable

  • Work with local partners to identify and share information on unmet diverse

needs within the community and gaps in community provision

  • Support development of community groups and assets who promote equity
  • Encourage people who have been connected to community support through

social prescribing to volunteer or to start their own activities and groups

  • Support existing local volunteering schemes to strengthen community

resilience and explore potential to develop a team of volunteers to provide

‘buddying support’, peer support or to start new community-based groups

or activities

Data capture

  • Support referral agencies to provide appropriate information about the person

they are referring to, including demographic data and data on wider

determinants, for example, caring status

  • Provide appropriate and timely feedback to referral agencies about the people

they referred

  • Work sensitively with people, their families and carers to capture key

information to measure impact of social prescribing on their health and well-

being, using validated tools determined locally such as the UCLA loneliness

scale and ONS4 well-being scale to assess need and measure outcomes

  • Encourage people, their families and carers to provide feedback on their

experience,(for example, through patient satisfaction surveys), and to share

their stories about the impact of social prescribing on their lives

  • Adhere to TrueNorth policies around data protection legislation and data

sharing agreements, ensuring people give appropriate consent

Continuing professional development

  • Work with a supervisor to undertake continual personal and professional

development in line with the social prescribing workforce framework

  • Take an active role in reflecting, reviewing and developing professional

knowledge, skills and behaviors

  • Attend appropriate mandatory training before working with people and be aware

of own competence, maintaining boundaries around scope of practice and

referring onwards for people whose needs fall outside of these boundaries

  • Adhere to organizational policies and procedures, including confidentiality,

safeguarding, lone working, information governance, equality, health and safety

training

Miscellaneous

  • Work as a TrueNorth team member to seek feedback, continually improve

service, and contribute to service planning.

  • Contribute to the development of policies and plans relating to equality,

accessibility, and health inequalities.

  • Undertake any tasks consistent with the level of the post and the scope of the

role, ensuring that work is delivered in a timely and effective manner.

  • Duties may vary from time to time, without changing the general character of

the post or the level of responsibility

SUPERVISORY RESPONSIBILITIES: This position does not have any supervisory

responsibilities.

QUALIFICATIONS:

To perform this job successfully, an individual must be able to perform each essential duty

satisfactorily. The requirements listed below are representative of the knowledge, skill,

and/or ability required. Reasonable accommodations may be made to enable individuals

with disabilities to perform the essential functions.

Required:

  • Bachelor’s Degree in human services or related field preferred
  • High school diploma or GED accepted
  • Prior experience planning special projects / events
  • Strong communication (written and oral)
  • Strong people skills, with the ability to work with individuals and groups of all ages,

skills, backgrounds, and personalities

  • Ability to work well independently and on a team
  • Attention to detail, follow up, and excellent organizational skills
  • Strong time management skills
  • Ability to maintain volunteer and agency confidentiality
  • Ability to problem solve and exercise good discretion
  • Proficiency with Microsoft Office and Google products
  • Commitment to TrueNorth’s mission, goals, and values

Preferred:

  • Two years of experience in communication and interpersonal skills
  • Two years of experience in nonprofits or a related field

EOE

Job Type: Full-time

Pay: $40,000.00 per year

Benefits:

  • 401(k)
  • Dental insurance
  • Employee assistance program
  • Flexible spending account
  • Health insurance
  • Life insurance
  • Paid time off
  • Vision insurance

Schedule:

  • 8 hour shift
  • Monday to Friday

Work Location: In person

Salary : $40,000

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