Service-users’ perspectives of link worker social prescribing: a qualitative follow-up study

Abstract

BackgroundSocial prescribing enables health-care professionals to address non-medical causes of ill-health by harnessing the resources of the voluntary and community sectors in patient care. Although increasingly popular in the UK, evidence for the effectiveness of social prescribing is inconclusive and longer-term studies are needed. This study aimed to explore experiences of social prescribing among people with long-term conditions one to two years after their initial engagement with a social prescribing service.MethodsQualitative methods comprising semi-structured follow-up interviews were conducted with 24 users of a link worker social prescribing service who had participated in an earlier study. Participants were aged between 40 and 74 years and were living in a socioeconomically-deprived area of North East England.ResultsParticipants reported reduced social isolation and improvements in their condition management and health-related behaviours. However, many participants had experienced setbacks, requiring continued support to overcome problems due to multi-morbidity, family circumstances and social, economic or cultural factors. Findings indicated that, in this sample of people facing complex health and socioeconomic issues, longer-term intervention and support was required. Features of the link worker social prescribing intervention that were positively appraised by participants, included a highly personalised service to reflect individual goal setting priorities and a focus on gradual and holistic change dealing with issues beyond health. The important role of a strong and supportive relationship with an easily-accessible link worker in promoting sustained behaviour change highlights the importance of link worker continuity. A lack of suitable and accessible voluntary and community services for onward referral acted as a barrier to involvement for some participants.ConclusionsThis study highlights issues of interest to commissioners and providers of social prescribing. Engagement with social prescribing for up to two years was examined and continued involvement was identified for those with complex issues, suggesting that a long-term intervention is required. The availability of onward referral services is an important consideration for social prescribing in a time of constrained public spending. From a research perspective, the range of improvements and their episodic nature suggest that the evaluation of social prescribing interventions requires both quantitative and qualitative data collected longitudinally.

Social prescribing

“…However, the lack of robust evidence of effectiveness does not mean social prescribing is ineffective. Findings from qualitative studies suggest that patients are satisfied with social prescribing schemes, particularly valuing a trusting and supportive relationship with their link worker, the time and space to address social problems, and link workers’ extensive knowledge of the range of community support services available 14151617. Recent systematic reviews of non-clinical community interventions identified evidence, albeit weak, of a further range of patient benefits 1218.…”

“…Provide patients with a full explanation of the social prescribing programme offered. This has been found to help manage patient expectations of the service and increase their satisfaction15…”

Social prescribing for individuals with mental health problems: a qualitative study of barriers and enablers experienced by general practitioners

“…There is emerging evidence that social prescribing activities can support people's mental health, with activities such as arts classes, gardening, and exercise schemes leading to increased empowerment, self-esteem, confidence, improved mental health outcomes and cognitive functioning, and lowered feelings of social exclusion and isolation [15][16][17]. Another social prescribing study found reductions in isolation and improvements in health-related behaviours and management of long-term conditions [18]. There is also growing evidence for the benefits of the common social prescribing 'model', that is, the referral from a GP, through a link worker, to community groups and activities.…”

A Polish Pilot Programme of Coordinated Care: A Herald of Change or a Missed Opportunity? A Critical Debate

“…We feel that the pilot would greatly benefit from multi-sectoral collaboration, especially with an aim to address complex health needs of deprived populations. In various coordinated care models around the world, it has often been achieved through collaboration between health care and social care (56,57). Furthermore, POZ Plus also entails a degree of functional integration in the form of selected support functions (a uniform IT system, management model, and reporting system), whose use is simply required by the government as the programme initiator and leader.…”