Constituting link working through choice and care: An ethnographic account of front‐line social prescribing

Griffith, Bethan; Pollard, Tessa M.; Gibson, Kate; Jeffries, Jayne; Moffatt, Suzanne

doi:10.1111/1467-9566.13569

Cited by 11 publications

(26 citation statements)

References 63 publications

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“…Coupled with the lack of understanding or ambivalence about the role from other primary care professionals, link workers sometimes felt that they were "treated as outsiders going apparently unrecognised by practice staff" (46) and sometimes found it di cult to become integrated and visible in primary care due to "entrenched professional hierarchies" (37) (37) .…”

Section: Synthesismentioning

confidence: 99%

“…The pressure of targets Organisational targets and service funding models that reward high referral volume and the completion of wellbeing assessments could in uence link workers' approaches to patient care. These targets may cause a drift towards social prescribing approaches that prioritise the completion of assessment instruments at the expense of more holistic person-centred care (37,46,51).Furthermore the pressure to generate a high number of referrals could mean they accepted clients not necessarily ready to engage with social prescribing, or those with complex needs (51).…”

Section: Organisational Buy-in To Social Prescribingmentioning

confidence: 99%

“…It was noted that link workers in larger organisations with clear organisational structures were more likely to be part of teams where workload could be shared and had better access to support and training (32). Those working in teams with other link workers could draw on them for emotional support and re ection (47), and this could help promote a sense of success in the role (37). Well-embedded workforce support and clinical supervision was key to being able to deal with the complex cases link workers found themselves working with (39).…”

Section: Support For Link Workersmentioning

confidence: 99%

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A meta-ethnography of the factors that shape link workers’ experiences of social prescribing

Turk,

Tierney,

Pope

et al. 2024

Preprint

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Background: Social prescribing is gaining traction internationally. It is an approach which seeks to acknowledge and address some of the effects of the social determinants of health by signposting people to support available in their local communities. It is hoped that social prescribing might improve health inequities and reduce reliance on healthcare services. In the United Kingdom, social prescribing link workers have become core parts of primary care teams. Despite growing the literature on the implementation of social prescribing, to date there has been no synthesis that develops a theoretical understanding of the factors that shape link workers’ experiences of their role. Methods: We undertook a meta-ethnographic evidence synthesis of qualitative literature to develop a novel conceptual framework that explains how link workers experience their roles. We identified eligible studies using a systematic search of key electronic databases, Google alerts, and through scanning reference lists of included studies. We followed the eMERGe guidance when conducting and reporting this meta-ethnography. Results: Our synthesis included 21 studies and developed a “line of argument” or overarching conceptual framework which highlighted inherent interrelated and interacting tensions present at each of the levels that social prescribing operates. These tensions may arise from a mismatch between the policy logic of social prescribing and the material and structural reality, which is shaped by social, political, and economic forces, into which it is being implemented. Conclusion: The tensions highlighted in our review may shape link workers’ experiences of their role. They may call into question the sustainability of social prescribing and the link worker role as currently implemented, as well as their ability to deliver desired outcomes such as improvement in health inequities or reductions in healthcare service utilisation. Greater consideration should be given to how the link worker role is defined, deployed, and trained. Furthermore, thought should be given to ensuring that the infrastructure into which social prescribing is being implemented into is sufficient to meet needs. Should social prescribing seek to improve outcomes for those experiencing social and economic disadvantage, it may be necessary for social prescribing models to allow for more intensive and longer-term modes of support.

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Section: Synthesismentioning

confidence: 99%

Section: Organisational Buy-in To Social Prescribingmentioning

confidence: 99%

Section: Support For Link Workersmentioning

confidence: 99%

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A meta-ethnography of the factors that shape link workers’ experiences of social prescribing

Turk,

Tierney,

Pope

et al. 2024

Preprint

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“…, 2022 , link worker social prescribing intervention (Griffiths et al. , 2023 ; Wildman & Wildman, 2023 ), therapeutic community gardening (Wood et al. , 2022 ), green exercise initiatives (Massey et al.…”

Section: Limitationsmentioning

confidence: 99%

Speaking the same language – a scoping review to identify the terminology associated with social prescribing

Newstead,

Elliott,

Cavanagh

et al. 2023

Prim Health Care Res Dev

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Aim: To identify the social prescribing-related terminology within the peer-reviewed literature of the UK and the grey literature from Wales. Background: Social prescribing has seen a period of development that has been accompanied by a proliferation of related terminology and a lack of standardisation in the manner in which it is employed. This creates barriers to engagement and impairs communication, both between professionals and members of the public. The Wales School for Social Prescribing Research and Public Health Wales committed to the development of a glossary of terms for social prescribing, to facilitate the clarification and standardisation of the associated terminology. Here, we describe the first step in that process. Method: A scoping review of the peer-reviewed UK literature and Welsh grey literature was conducted. The titles and abstracts of 46,242 documents and the full text of 738 documents were screened. Data were charted from 205 documents. Data capture included terminology, the location within the UK of the research or intervention described in the article, and the perspective from which the article was authored. A general inductive approach was used to categorise the terms by theme. Findings: This research serves to highlight the breadth and diversity of the terminology associated with social prescribing. Results demonstrate aspects of shared commonality and clear distinction between the terminology from the two literature sources. The greatest contributions of terms were from articles that examined research and/or interventions in England and that were authored from the perspective of health or health and social care. The research indicates that nation- and sector-specific terms may not be adequately represented in the literature at large. Looking forward, it will be important to ensure that social prescribing terminology within the UK literature is culturally relevant and accurately reflects the terminology used by the workforce who encounter and deliver social prescribing.

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“…Elsewhere the authors have engaged with social theory to examine the intervention from the perspectives of link workers 18 and clients 19 , 20 separately. Here the authors synthesise both parts of the research to explore how social prescribing was delivered and received, and implications for its ability to meet its stated aims.…”

Section: Introductionmentioning

confidence: 99%

Implementation and impact of a social prescribing intervention: an ethnographic exploration

Pollard

Gibson²,

Griffith³

et al. 2023

Br J Gen Pract

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Background: Social prescribing involves referral of patients from primary care to link workers, who work with them to access appropriate local voluntary and community sector services. Aim: Our aim was to explore how a social prescribing intervention was delivered by link workers and the experiences of those referred to the intervention. Design and Setting: We used ethnographic methods to conduct a process evaluation of a social prescribing intervention delivered to support those living with long-term conditions in an economically deprived urban area. Method: We used participant observation, shadowing, interviews and focus groups to examine the experiences and practices of 20 link workers and 19 clients over a period of 19 months. Results: Social prescribing provided significant help for some people living with long-term health conditions. However, link workers experienced challenges in embedding social prescribing in an established primary care and voluntary sector landscape. The organisations providing social prescribing drew on broader social discourses emphasising personal responsibility for health, which encouraged a drift towards an approach that emphasised empowerment for lifestyle change more than intensive support. Pressures to complete assessments, required for funding, also encouraged a drift to this lighter touch approach. A focus on individual responsibility was helpful for some clients, but had limited capacity to improve the circumstances or health of those living in the most disadvantaged circumstances. Conclusion: We conclude that careful consideration of how social prescribing is implemented within primary care is required if it is to provide the support needed by those living in disadvantaged circumstances.

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Constituting link working through choice and care: An ethnographic account of front‐line social prescribing

Cited by 11 publications

References 63 publications

A meta-ethnography of the factors that shape link workers’ experiences of social prescribing

A meta-ethnography of the factors that shape link workers’ experiences of social prescribing

Speaking the same language – a scoping review to identify the terminology associated with social prescribing

Implementation and impact of a social prescribing intervention: an ethnographic exploration

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