BackgroundSocial prescribing assists patients to engage insocial activities and connect to community supports as part of a holistic approach to primary care. Rx: Community was a social prescribing project, implemented within 11 community health centres situated across Ontario, Canada.AimsTo explore how social prescribing as a process facilitates positive outcomes for patients.Design and settingWe used qualitative methods, conducting 18 focus groups involving 88 patients and 8 additional in-depth interviews.MethodsInterviews and focus groups were transcribed verbatim and analyzed thematically using a theoretical framework based onself-determination theory.ResultsParticipants who had received social prescriptions described social prescribing as an empathetic process that respects their needs and interests. Social prescribing facilitated the patient’s voice in their care, helped patient’s develop skills in addressing needs important to them, and fostered trusting relationships with staff and other participants. Patients reported their social support networks were expanded, and they had improved mental health and ability in self-management of chronic conditions. Patients who became involved in social prescribing as voluntary “health champions” reported this was a positive experience and they gained a sense of purpose by giving back to their communities in ways that felt meaningful for them.ConclusionSocial prescribing produced positive outcomes for patients, and fit well within the community health centre model of primarycare. Future research should examine the impact on health outcomes and examine the return on investment of developing and implementing social prescribing programs.

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See the response from https://doi.org/10.1111/jgs.16253 et al.

BackgroundThere has been a large-scale adoption of virtual delivery of primary care as a result of the COVID-19 pandemic.AimIn this descriptive study, an equity lens is used to explore the impact of transitioning to greater use of virtual care in community health centres (CHCs) across Ontario, Canada.Design & settingA cross-sectional survey was administered and electronic medical record (EMR) data were extracted from 36 CHCs.MethodThe survey captured CHCs‘ experiences with the increased adoption of virtual care. A longitudinal analysis of the EMR data was conducted to evaluate changes in health service delivery. EMR data were extracted monthly for a period of time before the pandemic (April 2019–February 2020) and during (April 2020–February 2021).ResultsIn comparison with the pre-pandemic period, CHCs experienced a moderate decline in visits made (11%), patients seen (9%), issues addressed (9%), and services provided (15%). During the pandemic period, an average of 54% of visits were conducted virtually, with telephone as the leading virtual modality (96%). Drops in service types ranged from 28%–82%. The distribution of virtual modalities varied according to the provider type. Access to in-person and virtual care did not vary across patient characteristics.ConclusionThe results demonstrate a large shift towards virtual delivery while maintaining in-person care. No meaningful differences were found in virtual versus in-person care related to patient characteristics or rurality of centres. Future studies are needed to explore how to best select the appropriate modality for patients and service types.

Introduction The Alliance for Healthier Communities represents community‐governed healthcare organizations in Ontario, Canada including Community Health Centres, which provide primary care to more disadvantaged populations. Methods In this experience report, we describe the Alliance's journey towards becoming a learning health system using examples for organizational culture, data and analytics, people and partnerships, client engagement, ethics and oversight, evaluation and dissemination, resources, identification and prioritization, and deliverables and impact. Results Many of the foundational elements for a learning health system were already in place at the Alliance including an integrated and accessible data platform. Leadership championed and embraced the movement towards a learning health system, which led to restructuring of the organization. This included role changes for data support personnel, better communication, and dissemination plans, strategies to engage clinicians and other front‐line staff, restructuring of committees for more collaborative planning and prioritization of quality improvement and research initiatives, and the development of a new Practice‐Based Learning Network for more opportunities to use the data for research and evaluation. Conclusions Next steps will focus on continued clinical engagement and partnerships as well as ongoing reflection on the transition and success of the learning health system work.