Governance, Safety and Accountability in Social Prescribing: What Should Be in Place Before Connecting People to Community Support?

Governance, Safety and Accountability in Social Prescribing: What Should Be in Place Before Connecting People to Community Support?

Category: Implementation & Practice

Social prescribing is often described in simple terms: understand what matters to a person and help connect them with appropriate support in the community. That simplicity is part of its appeal. But once a healthcare organization, professional or navigator begins making structured connections between people and community services, important questions follow. Is the connection appropriate? Has the person made an informed choice? Is the community resource suitable and able to support them? What information needs to be shared? And what happens if risk emerges, the connection does not work, or something goes wrong?

These are governance questions, even when the support being offered is non-clinical. A community activity may be informal, welcoming and low-cost, but that does not automatically make every referral appropriate or safe. Responsible social prescribing needs enough governance to protect people, clarify responsibilities and support learning, without turning community connection into an unnecessarily bureaucratic process.

A referral creates a pathway, not simply a hand-off

The World Health Organization describes social prescribing as a way of connecting people with non-clinical services in the community to improve health and well-being. Importantly, WHO does not present one model that every health system should reproduce. Its implementation toolkit recognizes that social prescribing can be organized in different ways and that implementation materials should be adapted to local context.

That distinction matters for Viet Nam. Social prescribing should not mean that a healthcare service identifies a social need, gives someone the name or telephone number of a community organization and considers its responsibility complete. Depending on the model and the person's needs, the pathway may include identifying relevant needs, discussing priorities and options, determining whether community-based support is appropriate, supporting the connection, sharing necessary information in accordance with applicable law, responding to problems and following up when that is warranted.

Evidence from the Western Pacific reinforces the importance of context. A 2026 scoping review identified 42 peer-reviewed studies and 13 grey-literature sources across the region, with substantial variation in program structure, funding, target populations and referral arrangements. Resource constraints and inconsistent referral processes were among the recurring implementation challenges. Only one of the peer-reviewed studies came from Viet Nam, highlighting how limited the local evidence base remains.

This does not mean Viet Nam must wait for a large evidence base before beginning to explore social prescribing. It does mean that early models should be treated as locally adapted implementation efforts that require appropriate governance, monitoring and learning rather than as simple transfers of models developed elsewhere.

Define the scope before making the connection

Safe implementation starts with clarity about what social prescribing can reasonably do and where its role ends. Organizations need to define who the pathway is intended for, what kinds of needs it may address, who can initiate or receive referrals, what a navigator or equivalent role is expected to do, and when another service should take over.

Social prescribing may help people connect with activities and resources related to social participation, physical activity, peer support, practical assistance, welfare or financial advice, learning, culture, healthy living and other forms of community-based support. It should not replace clinical assessment, medical treatment, emergency care, specialist mental health care, professional social work or appropriate protection services when these are needed.

This boundary matters because an apparently social problem may coexist with a more serious clinical, psychological or protection issue. Loneliness may accompany severe depression. Financial hardship may coexist with exploitation or unsafe living conditions. A request for community support may reveal violence, abuse or another urgent risk. A navigator does not need to diagnose every problem, but a safe pathway should help people recognize when a concern falls outside their role and know where to escalate it.

NHS England's updated 2026 workforce framework offers a useful international example. It emphasizes a defined scope of practice, competencies, employer support, supervision and multidisciplinary working so that social prescribing link workers can practise safely and effectively. These arrangements should not simply be copied into Viet Nam, but the underlying principle is transferable: people working at the interface between healthcare and community support need clear boundaries and access to appropriate support.

Choice, consent and information sharing need to be meaningful

Social prescribing is intended to be person-centered. The starting point should therefore not be, “We have this activity available, so we should send you there.” It should be a conversation about what matters to the person, what they would like help with, what options are realistically available and whether they want to pursue them.

People should understand what is being suggested, what the community organization or activity provides and, where information needs to be shared, what information will be used and for what purpose. A person may accept one form of support while declining another. Where social prescribing is offered as an optional form of support, declining it should not by itself affect access to appropriate healthcare.

Relevant principles already exist in Viet Nam's legal framework, although they should not be confused with a specific social prescribing law. Nghị định 110/2024/NĐ-CP on social work, effective since 15 October 2024, includes principles of respecting people's choices and decisions, encouraging their participation in decisions affecting their lives and building on their existing strengths and resources. It also recognizes the right to refuse social-work services when a person considers them unsuitable. These provisions regulate social work, not social prescribing, but they offer useful domestic principles that may inform person-centered and community-connected care.

Information governance requires equal attention. A community organization will rarely need a person's complete medical record simply to arrange participation in an agreed activity or service. Referral processes should have a clear purpose, and any collection or sharing of personal information should remain within the relevant purpose and comply with applicable law.

This became particularly important in Viet Nam from 1 January 2026, when the Law on Personal Data Protection No. 91/2025/QH15 and Decree No. 356/2025/ND-CP took effect. The law requires personal data to be collected and processed within a specific and clear scope and purpose. It also contains specific provisions for health information. Article 26 requires the consent of the data subject in the collection and processing of health information, except in circumstances provided by law, together with compliance with other applicable personal-data protection requirements.

For a social prescribing pathway, privacy should therefore be designed into the process from the beginning. Organizations should understand what information is being collected, why it is needed, who can access it, whether it needs to move between organizations and how it will be protected. The precise requirements will depend on the information involved, the organizations participating, the purpose of processing and the applicable legal provisions. Social prescribing does not create an exception to data-protection requirements simply because the intended purpose is supportive.

Safety needs a clear route for escalation

Most people using social prescribing will not require an emergency or high-risk response, and responsible implementation should avoid medicalizing ordinary social needs. At the same time, organizations should not wait until a serious situation occurs before deciding what staff or community partners should do.

A navigator should know whom to contact when a person appears to need urgent healthcare, specialist mental health assessment, protection from violence or abuse, professional social-work intervention or another response beyond the scope of the social prescribing pathway. Community partners should also know how to raise concerns if significant risk becomes apparent after the connection has been made. People working within the pathway should not be left to improvise these decisions alone.

Viet Nam already has relevant domestic experience in hospital social work. Thông tư 51/2024/TT-BYT, effective from 1 March 2025, applies to healthcare facilities licensed to operate as hospitals. It requires hospital social-work services to assess psychological and social risks and needs; pay particular attention to people who may be experiencing violence, abuse or other circumstances requiring urgent assistance; coordinate with relevant departments and organizations; and, where necessary, refer people to healthcare, education, police or other appropriate organizations. It also addresses intervention planning, monitoring and evaluation.

These are hospital social-work requirements, not social prescribing requirements. The distinction should remain clear. Nevertheless, they demonstrate that assessment, coordination, referral, follow-up and escalation are already recognized elements of responsible psychosocial support within the Vietnamese hospital system. Future social prescribing initiatives can learn from these structures without treating the two practices as interchangeable.

Know the community resource before referring people to it

A directory is useful, but a list of organizations and telephone numbers is not yet a functioning referral network. Before routinely connecting people to a community resource, those designing the pathway should have a practical understanding of what that resource actually offers, who it is intended for, how people access it, whether there is a cost, whether it is accessible and whether it currently has capacity.

The level of assurance should be proportionate to the activity and the people involved. A public walking group and a service making home visits to vulnerable people do not carry the same risks. An informal neighborhood activity should not automatically be expected to meet the same organizational requirements as a professional service. At the same time, an activity should not be assumed to be safe or appropriate simply because it is community-based and well intentioned.

Depending on the nature of the service, reasonable questions may include whether staff or volunteers have appropriate preparation, how significant risks are managed, what happens when someone needs help beyond the service's capability, how complaints or incidents are handled, how personal information is managed, whether people with disabilities or other access needs can participate, and what happens when capacity is reached.

Recent international evidence supports this broader view. A global scoping review published in July 2026 synthesized 115 peer-reviewed empirical studies and found that social prescribing appears to depend not simply on referral pathways, but also on relational continuity, community capacity and local implementation conditions. Reported barriers included socioeconomic disadvantage, unstable funding, limited community-sector capacity, workforce pressures and weak integration across services.

This is why governance should not become a certification exercise that excludes useful grassroots initiatives. Community-connected care depends on local relationships, community assets and different forms of participation. The purpose of proportionate assurance is to make connections more reliable and safer, not to turn every community organization into a healthcare provider.

Follow-up should match need, risk and complexity

One of the simplest governance questions is also one of the most important: what happens after the referral?

Knowing that a referral was sent is not the same as knowing that a meaningful connection occurred. Someone may be unable to contact the organization, face a long waiting list, find transportation difficult, discover an unexpected cost, not meet the eligibility criteria or simply decide that the activity is not right for them.

The appropriate level of follow-up should vary. A person joining a low-risk community activity may require little or no formal follow-up. Someone with multiple social needs, greater vulnerability or a more complex pathway may need more active navigation and a clearer closed-loop process. Governance should define when follow-up is appropriate, who is responsible for it and what should happen when a connection repeatedly fails.

A failed connection should not automatically be interpreted as failure by the person. It can reveal important problems in the system: inaccessible transport, affordability, language barriers, unsuitable referral criteria, lack of community capacity, waiting lists, poor coordination or an option that simply does not match what the person wants. These are implementation findings worth learning from.

Roles, supervision and accountability need to be clear

A sustainable social prescribing model cannot depend indefinitely on one highly motivated individual who happens to know the local community. People performing navigation or link functions need appropriate preparation, clear boundaries, access to advice and, where the role requires it, supervision.

NHS England's 2026 workforce framework specifically emphasizes standards of practice, employer support, supervision, learning and development for social prescribing link workers. Again, this is not a model that Viet Nam is required to adopt. It is useful because it illustrates a broader principle: workforce support is part of service quality and safety, not simply an optional benefit for staff.

Viet Nam's social-work framework is also becoming more structured. Thông tư 29/2026/TT-BYT, effective from 25 August 2026, regulates social-work practice and continuing social-work knowledge. Its practice and continuing-knowledge frameworks cover areas including professional ethics, assessment, case management, counselling and psychosocial support, resource connection, interdisciplinary coordination, service processes, records, quality assurance, professional supervision and continuous improvement.

These are requirements relating to social-work practice and professional development; they should not automatically be imposed on every future social prescribing navigator or community role. They are, however, relevant when deciding which activities may reasonably be undertaken by a trained navigator and which require a qualified professional. Social prescribing should complement professional roles, not blur them.

Accountability also becomes more complicated when several organizations are involved. A healthcare provider, navigator, social worker, community organization and family may all contribute to the same person's journey, but shared involvement should not result in unclear responsibility.

Before implementation, a pathway should therefore make practical responsibilities explicit: who determines whether the pathway is appropriate, who discusses consent and information sharing, who makes the connection, who responds when risk is identified, who records relevant information, when follow-up occurs, how concerns or incidents are escalated, and who reviews whether community partners remain appropriate.

This does not mean that one organization becomes responsible for everything another organization does. A community organization remains responsible for the activities and services it provides, while healthcare professionals remain responsible for clinical decisions within their roles. Legal responsibilities will depend on the organizations involved, professional scopes, contractual arrangements and applicable law. The governance goal is not unlimited shared liability; it is to prevent important responsibilities from disappearing at the interfaces between services.

Measure safety, equity and pathway performance, not only referral numbers

It is easy to count referrals. It is much harder, but more useful, to understand whether the pathway is actually working.

Evaluation should therefore go beyond the number of people referred or the number who attend an activity. Depending on the stage and scale of implementation, useful indicators may include referrals that cannot be completed, waiting times, community services repeatedly reaching capacity, inappropriate referrals, escalation events, complaints, incidents, privacy or data-protection problems, accessibility barriers, reasons for non-participation and differences in successful connection between population groups.

The objective is not to create a punitive reporting system around community activity. It is to identify patterns early enough to improve the pathway. If one population group is consistently less likely to complete a connection, for example, the question should not simply be whether they are “engaging.” The pathway should examine transport, affordability, language, cultural relevance, disability access, digital exclusion, eligibility rules and whether the available community resources actually match people's needs and preferences.

This is particularly important while social prescribing remains at an early stage in Viet Nam. Regional and global evidence published in 2026 shows substantial variation in how social prescribing is organized, implemented and evaluated, while the evidence base remains concentrated in a relatively small number of countries. The global review also found psychosocial outcomes to be reported more consistently than clinical or system-level effects. Early Vietnamese initiatives should therefore pay close attention to feasibility, acceptability, pathway function, equity, community capacity and safety rather than expecting a new program immediately to demonstrate large reductions in healthcare utilization or other mature system-level outcomes.

What could responsible governance look like in Viet Nam?

Viet Nam should not assume that a social prescribing model developed in England or elsewhere can be transferred wholesale into its own healthcare and community systems. WHO's implementation approach and emerging evidence from the Western Pacific both support adaptation to local context rather than a one-size-fits-all model.

Nor does Viet Nam need to create an elaborate national governance structure before responsible local experimentation is possible. A reasonable pilot could begin with a clearly defined population and purpose, locally mapped community resources, transparent inclusion and referral criteria, person-centered decision-making, proportionate assurance of community partners, lawful and purpose-specific information handling, clear escalation arrangements, appropriately supported staff, follow-up matched to need, and a small set of meaningful implementation, quality, safety and equity measures.

The organizational model may differ by setting. A hospital may be able to build parts of a pathway around its existing social-work function and community relationships. Other healthcare or community settings may use different forms of navigation. Some people will need professional social-work involvement; others may benefit from a trained navigator, healthcare professional, peer or community organization. The appropriate design should depend on people's needs, level of risk, required competencies and the local system rather than on importing a particular job title.

Existing Vietnamese law provides relevant foundations through Nghị định 110/2024/NĐ-CP on social work, Thông tư 51/2024/TT-BYT on social work in hospitals, Thông tư 29/2026/TT-BYT on social-work practice and continuing knowledge, and the personal-data protection framework in force since January 2026. These instruments do not themselves establish a national social prescribing framework, and they should not be described as doing so. They do, however, reinforce principles highly relevant to responsible community-connected care: respect for people's choices, clear professional boundaries, appropriate assessment and referral, coordination, quality, information protection and accountability.

From connection to responsible connection

The strength of social prescribing is that it looks beyond the walls of healthcare and recognizes that health and well-being are shaped by relationships, everyday circumstances, participation, practical needs and community life. Preserving that strength means resisting the temptation to turn community organizations into extensions of the medical system.

At the same time, connecting healthcare with community resources creates new interfaces where information moves, responsibilities meet and people can sometimes fall between services. Good governance makes those interfaces more reliable. It helps keep the person at the center, treats community organizations as partners rather than destinations for transferred workload, supports people working within appropriate boundaries, protects information and creates a route back to clinical, social-work or other professional support when community connection alone is not enough.

For Viet Nam, that may be one of the most important principles for developing social prescribing responsibly: the objective is not simply to make more referrals. It is to build connections that are appropriate, informed, safe, accountable and capable of learning and improving over time.

References

1. World Health Organization Regional Office for the Western Pacific. A toolkit on how to implement social prescribing. Manila: WHO Regional Office for the Western Pacific; 2022.

2. NHS England. Workforce Development Framework for Social Prescribing Link Workers. Version 2. Updated July 2026; published 13 August 2026.

3. Lwin KS, Wong MSJ, Tan MH, et al. Organization and implementation of social prescribing in the Western Pacific Region: a scoping review. The Lancet Regional Health – Western Pacific. 2026;67:101714. doi:10.1016/j.lanwpc.2025.101714.

4. Kisa A, Kisa S. Models, implementation, and reported outcomes of social prescribing interventions: a scoping review. Frontiers in Public Health. 2026;14:1871347. doi:10.3389/fpubh.2026.1871347.

5. Government of Viet Nam. Decree No. 110/2024/ND-CP on Social Work. Issued 30 August 2024; effective 15 October 2024.

6. Ministry of Health of Viet Nam. Circular No. 51/2024/TT-BYT on the Implementation of Social Work in Medical Examination and Treatment Establishments. Issued 31 December 2024; effective 1 March 2025.

7. Ministry of Health of Viet Nam. Circular No. 29/2026/TT-BYT on Social Work Practice and Continuing Social Work Knowledge. Issued 6 July 2026; effective 25 August 2026.

8. National Assembly of Viet Nam. Law No. 91/2025/QH15 on Personal Data Protection. Issued 26 June 2025; effective 1 January 2026.

9. Government of Viet Nam. Decree No. 356/2025/ND-CP detailing certain articles and measures for implementation of the Law on Personal Data Protection. Issued 31 December 2025; effective 1 January 2026.