“Winging It”: An Exploration of the Self-Perceived Professional Identity of Social Prescribing Link Workers

Moore, Coco; Unwin, Peter; Evans, Nick; Howie, Frances

doi:10.1155/2023/8488615

Cited by 4 publications

(17 citation statements)

References 27 publications

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“…Link workers were sometimes used to " ll gaps", which is an identi ed risk of having unclear professional identities in newer professions (44). In the studies, parameters of the link worker role were frequently exceeded due to concerns that nobody would support patients otherwise, because "no other professions would deviate from their role boundaries" (44) (p.5).…”

Section: Synthesismentioning

confidence: 99%

“…The lling of gaps was particularly pertinent in the context of overstretched and underfunded statutory and mental health services. In these contexts, link workers often ended up taking on more clinical risk (40,44) or providing more specialist support such as acting as unquali ed social or advocacy workers (40), due to long waiting lists or lack of availability for more specialised services. Not having onward referral options may also limit link workers' ability to set boundaries with service users (49,51).…”

Section: Synthesismentioning

confidence: 99%

“…The quasi-professional status of the link worker role Link workers have been introduced into the health and care system as a new "professional" role, but without the formal training and registration that would afford them professional status (35) and identity to give them the con dence needed to deal with complex cases they encounter in their work (44,47).…”

Section: Synthesismentioning

confidence: 99%

“…Formal training is considered essential for the building of professional identity and status (44), however, across the studies there was variation in the training link workers had received. While formal training could increase link worker con dence in performing their role (51), some link workers reported that it was often minimal, inconsistent and non-standardised (44). Some needed to draw on skills and training they received in previous roles (44); those taking on more senior responsibilities felt like they did not have enough training for this (32).…”

Section: Synthesismentioning

confidence: 99%

“…While formal training could increase link worker con dence in performing their role (51), some link workers reported that it was often minimal, inconsistent and non-standardised (44). Some needed to draw on skills and training they received in previous roles (44); those taking on more senior responsibilities felt like they did not have enough training for this (32). In other contexts link workers re ected that the training they had received was overly theoretical and lacked practical elements to prepare them for dealing with the range, severity, and complexity of issues they encountered (47,51); or with speci c health conditions (48).…”

Section: Synthesismentioning

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: Synthesismentioning

confidence: 99%

Section: Synthesismentioning

confidence: 99%

Section: Synthesismentioning

confidence: 99%

Section: Synthesismentioning

confidence: 99%

See 3 more Smart Citations

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

Turk,

Tierney,

Pope

et al. 2024

Preprint

View full text Add to dashboard Cite

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

Turk,

Tierney,

Hogan

et al. 2024

BMC Med

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Background Social prescribing is gaining traction internationally. It is an approach which seeks to address non-medical and health-related social needs through taking a holistic person-centred and community-based approach. This involves connecting people with and supporting them to access groups and organisations within their local communities. It is hoped that social prescribing might improve health inequities and reduce reliance on healthcare services. In the UK, social prescribing link workers have become core parts of primary care teams. Despite growing 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 studies using a systematic search of key 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 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, shaped by social, political, and economic forces, into which it is being implemented. Conclusions The tensions highlighted in our review 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 reducing health inequities or 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 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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Patient buy-in to social prescribing through link workers as part of person-centred care: a realist evaluation

Tierney,

Wong,

Westlake

et al. 2024

Health Soc Care Deliv Res

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Background Social prescribing link workers have become part of primary health care in recent years. They help patients to recognise non-medical factors affecting their health and identify sources of support, often in the voluntary, community and social enterprise sector. They form part of wider work to strengthen person-centred care, which actively seeks to engage individuals in decision-making about their health, taking into account their medical, social, psychological, financial and spiritual circumstances. Objective To understand how buy-in to social prescribing and the link worker role is established for a patient, and how this relates to person-centred care. Design A realist evaluation. Setting Patients engaging with link workers in seven different parts of England were involved. Methods As part of data collection, we observed link workers interacting with 35 patients. We also interviewed 61 patients and re-interviewed 41 of them 9–12 months later. Data were coded and developed into context–mechanism–outcome configurations, which were used to produce a programme theory. Results Data highlighted how patients might be uncertain about the link worker role but agree to a referral as they sought assistance with their non-medical issues. Patients talked about experiencing a sense of hope through the trust they developed in a link worker. This trust was established through the communication skills and knowledge demonstrated by a link worker, and by their ability to act as an anchor point when required – a reliable, consistent source of support to whom patients could offload. The link worker role also involved connecting patients to external support, which called for sensitivity around how ready someone was to move forward; this was shaped by a patient’s motivation but also their capacity to make changes given other demands in their life. Connecting patients to external support could be affected by structural factors outside the link workers’ control (e.g. housing options or employment opportunities). Limitations We did not interview patients who had rejected the offer of social prescribing, and most had a positive view of meeting with a link worker. Conclusions Person-centred care is engendered by link workers through their skills, knowledge and ability to respond to the individual readiness of patients to engage with external support. It can be curtailed by structural factors outside link workers’ sphere of control, such as access to housing or caring responsibilities of patients. This can hinder patients’ ability to ‘connect to’, leaving link workers to continue ‘connecting with’ patients as they act as an anchor point. Future work Exploration is required of factors affecting patients who interact with a link worker but do not access external support. Longitudinal work with a cohort of patients, speaking to them on a regular basis, may provide further understanding in this respect. Funding This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme as award number NIHR130247.

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“Winging It”: An Exploration of the Self-Perceived Professional Identity of Social Prescribing Link Workers

Cited by 4 publications

References 27 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

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

Patient buy-in to social prescribing through link workers as part of person-centred care: a realist evaluation

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