Link worker perspectives of early implementation of social prescribing: A 'Researcher-in-Residence' study.

Emma Hazeldine,Kerryn Husk,Sheena Asthana,Gemma Gowan,Julie Pollard,Rachel Wigglesworth

doi:10.1111/hsc.13295

Emma Hazeldine, Kerryn Husk + Show 4 more

Open Access

https://doi.org/10.1111/hsc.13295

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Abstract

Social prescribing (SP) is increasing in popularity in the UK and can enable healthcare providers to respond more effectively to a range of non-clinical needs. With the NHS commitment to establish an SP link worker in all GP practices, there is a rapid increase in the number of SP schemes across the country. There is currently insufficient evidence concerning the implementation and acceptability of SP schemes. In this paper, we report our analysis of the descriptions of the experiences of SP link workers, regarding the early implementation of SP link workers in two SP programmes in the South West. Data were gathered using the 'Researcher in Residence' (RiR) model, where the researcher was immersed in the environments in which the SP was managed and delivered. The RiR undertook conversations with 11 SP link workers, 2 SP link worker managers and 1 SP counsellor over six months. The RiR visited seven link workers at their GP practices (service 1) and four at their head office (service 2). The RiR met with the link worker managers at their offices, and the RiR spoke with the SP counsellor on the telephone. Data from these conversations were analysed using Thematic Analysis and six codes were constructed to advance our understanding of the components of early implementation of the SP programmes. Training (particularly around mental health), workforce support, location and SP champions within GP practices were found to be key strategies of SP implementation, link worker involvement acting as a conduit for the impacts of these strategies. This paper suggests that the implementation of SP programmes can be improved by addressing each of these areas, alongside allowing link workers the flexibility and authority to respond to challenges as they emerge.

Highlights

The prescribing of non‐medical, community or social activities is scaling rapidly around the world as a way of helping people manage and prevent illness, improve their health and well‐ being and address the wider determinants of health and inequalities (Pescheny, Randhawa & Pappas, 2019)
We report analysis of rich descriptions of the early implementation of link worker social prescribing, to assess how this series of relationships functions and the key barriers and facilitators experienced on the ground
Mental health severity (1) Individuals reported a proliferation of referrals where those referred were experiencing moderate to severe mental health problems that were outside the remit of the link worker

Summary

Introduction

The prescribing of non‐medical, community or social activities is scaling rapidly around the world as a way of helping people manage and prevent illness, improve their health and well‐ being and address the wider determinants of health and inequalities (Pescheny, Randhawa & Pappas, 2019) These approaches often labelled 'social prescribing', are designed to support the non-clinical needs of people who may need support with their mental health, who are lonely or isolated and who have long-term conditions or complex social needs that affect their wellbeing (Polley, Fleming, Anfilogoff & Carpenter, 2017; Polley, Bertotti, Kimberlee, Pilkington & Refsum 2017). Fewer studies have assessed impacts on service use, some reporting a reduction in demand for GP services, A&E, or secondary care use where social prescribing is adopted, others seeing an increase where unmet need is being addressed (Elston, 2018; Polley et al, 2017)

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