Social prescribing during the COVID-19 pandemic: a qualitative study of service providers’ and clients’ experiences

Abstract

Background COVID-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. Methods Data 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. Results The 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. Conclusions Social 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.

Tailoring cultural offers to meet the needs of older people during uncertain times: a rapid realist review

“…We also know that the delivery of social prescribing has changed due to Covid-19, with more interaction between link workers and people they support being undertaken remotely (rather than face-to-face) [78,79]. Link workers had to be agile in their response to the pandemic [80], as services and activities in the community to refer people on to closed or moved online. It also called for cultural providers to be creative in how they continued to engage with the public when buildings were closed [81][82][83].…”

Effect of social prescribing link workers on health outcomes and costs for adults in primary care and community settings: a systematic review

“…49 Since the pandemic, link workers have adapted to restrictions and use more remote supports, which has impacted participants’ experiences. 50 The impact of this on outcomes is yet to be evaluated.…”

“…Further research is also needed to better understand the components of social prescribing and indeed this is underway 49. Since the pandemic, link workers have adapted to restrictions and use more remote supports, which has impacted participants’ experiences 50. The impact of this on outcomes is yet to be evaluated.…”

Social prescribing for older people and the role of the cultural sector during the COVID ‐19 pandemic: What are link workers' views and experiences?

“…Several researchers have explored the impact of COVID‐19 on social prescribing (e.g. Fixsen et al, 2022 ; Morris et al, 2022 ; Westlake et al, 2022 ), a time when link workers had to be agile and open to change. During the first half of 2020, conversations that link workers had with patients often focused on immediate needs—such as food and medical supplies, or information on guidelines to stop the spread of COVID‐19.…”

“…These conversations had to be carried out remotely rather than face‐to‐face. It could be harder to develop a rapport online or by telephone, although there were reports of some individuals engaging and being more open with link workers when communicating remotely (Morris et al, 2022 ).…”