Loneliness and social isolation affect physical and mental health outcomes for older adults at rates that justify clinical intervention. Hospitals increasingly recognise that addressing these factors requires going beyond traditional medical treatment to connect patients with community resources that support wellbeing and prevent avoidable health complications.
To address this hidden health crisis, a major hospital-based initiative is shifting the focus from clinical treatments to community connection through “social prescribing.”
Backed by a $665,636 grant from the Ramsay Hospital Research Foundation, the NORTH Foundation and the Northern Sydney Local Health District (NSLHD) have partnered to embed social prescribing directly into routine hospital care. Led by Dr Rosanne Freak-Poli at Monash University, the program targets patients over 60 who are managing cancer, mental health conditions, cardiovascular disease, or musculoskeletal disease.
Prescribing Community
Rather than relying solely on medical interventions, social prescribing formally connects patients to non-clinical community services. Hospital staff facilitate referrals to local social groups, tailored exercise programs, and volunteering opportunities, providing patients with a structured pathway to rebuild their support networks and regain a sense of purpose.
Anthony Schembri AM, Chief Executive of the NSLHD, describes the approach as a vital evolution in comprehensive patient care.
“For our older Australians, this work is especially important,” Schembri said. “Embedding social prescribing into hospital care is a powerful opportunity to improve wellbeing, strengthen connections and create sustainable change that can be scaled across the system. We can build a model of care that goes beyond medicine.”
Built on Lived Experience
A core strength of the initiative is its collaborative foundation. The model is shaped through a two-stage, co-design approach that brings together patients with lived experience, carers, clinicians, and local councils from the very beginning.
Through focused workshops and consultations, a dedicated design team works side-by-side to ensure the resulting programs are practical, highly relevant, and grounded in the daily realities of life after hospital care.
The ultimate goal of the intervention is twofold: to improve the quality of life for vulnerable older adults and to prevent avoidable hospital readmissions driven by isolation and functional decline.
Gil Lorquet, CEO of the NORTH Foundation, noted that the investment represents a significant step forward for community health and practical hospital reform.
“Being entrusted with administering a grant of this significance reflects the confidence placed in our governance, capability and ability to deliver meaningful impact for our community,” Lorquet said.
If successful, this holistic, person-centred model could be scaled across broader hospital networks, fundamentally changing how the healthcare system supports ageing populations to live well at home.
Ritchelle is Content Team Manager at Akolade, producing stories for Australia's not-for-profit sector at Third Sector.
Trending
Popular
