Abstract
BackgroundCOVID-19 public health restrictions, such as social distancing and self-isolation, have been particularly challenging for vulnerable people with health conditions and/or complex social needs. Link worker social prescribing is widespread in the UK and elsewhere and is regarded as having the potential to provide support to vulnerable people during the pandemic. This qualitative study explores accounts of how an existing social prescribing service adapted to meet clients’ needs in the first wave of the pandemic, and of how clients experienced these changes.MethodsData were collected in a deprived urban area of North East England via remote interviews with clients (n = 44), link workers (n = 5) and service provider managerial staff (n = 8) from May–September 2020. Thematic data analysis was conducted.ResultsThe research found that service providers quickly adapted to remote intervention delivery aiming to serve existing clients and other vulnerable groups. Service providers experienced improved access to some existing clients via telephone in the first months of remote delivery and in some cases were able to engage clients who had previously not attended appointments at GP surgeries. However, link workers also experienced challenges in building rapport with clients, engaging clients with the aims of the intervention and providing a service to digitally excluded people. Limited link worker capacity meant clients experienced variable contact with link workers with only some experiencing consistent support that was highly valued for helping to manage their conditions and mental wellbeing. Limited access to linked services also adversely affected clients. Clients living in less affluent circumstances and/or with worse health were more likely to experience negative impacts on their long-term condition. Some found their health and progress with social prescribing was ‘on hold’ or ‘going backwards’, which sometimes negatively affected their health.ConclusionsSocial prescribing offered valued support to some during the pandemic, but remote support sometimes had limited impact for clients and findings highlight the vulnerability of social prescribing’s success when linked services are disrupted. Findings also show the need for more to be done in the upscaling of social prescribing to provide support to digitally excluded populations.
Highlights
COVID-19 public health restrictions, such as social distancing and self-isolation, have been challenging for vulnerable people with health conditions and/or complex social needs
Social prescribing takes varying forms ranging from signposting to holistic support [6, 7]; the key component tends to be a non-medical ‘link worker’ who helps patients achieve personalised health goals by referring them into a range of non-clinical local voluntary, community and social enterprise (VCSE) sector activities, services or groups, as well as resources supplied by local government and health services
The intervention had originally been commissioned by the local Clinical Commissioning Group and was managed and delivered by VCSE organisations; patients were referred by a health care professional at their GP surgery and link workers were attached to GP surgeries
Summary
COVID-19 public health restrictions, such as social distancing and self-isolation, have been challenging for vulnerable people with health conditions and/or complex social needs. Link worker social prescribing is widespread in the UK and elsewhere and is regarded as having the potential to provide support to vulnerable people during the pandemic This qualitative study explores accounts of how an existing social prescribing service adapted to meet clients’ needs in the first wave of the pandemic, and of how clients experienced these changes. The UK governments’ COVID-19 response included a national ‘lockdown’ with additional guidance for clinically vulnerable people, which included those with Type 2 diabetes mellitus (T2DM) [3]. Social prescribing is regarded as an intervention with potential to be remodelled to meet exacerbated public health challenges by supporting those most vulnerable to the impact of COVID-19 and social distancing [14, 15]. During much of 2020, health services were overwhelmed, and support offered by link workers was considered to be an important resource for vulnerable people [15]
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