Multi-region evaluation of the national roll out of social prescribing link workers in primary care
What are we trying to do?
Social prescribing, sometimes known as community referral, is where doctors and nurses work with someone called a 'link worker' to help patients find services from local, voluntary and community groups to improve their health and wellbeing. Link workers are now being introduced by the NHS across the UK. Link workers support people with emotional and practical needs by considering all aspects of their lives not just their medical needs. Their role is to help connect people to information, advice, activities and other services provided by a range of voluntary and community groups.
Our overall aim is to take a multi-regional approach to map current provision and service configuration and to assess whether access, engagement and outcomes vary by delivery model, geography and population characteristics over time. We want to find out how link worker services operate, how well they work, who does and doesn't use them, whether they are of benefit to people and are a good use of NHS resources.
Why is it important?
Social prescribing links patients in primary care with sources of support within the community. To date, research on social prescribing has evaluated the effects of individual services usually in isolation from the wider health system in which they are situated. It is well documented that this evidence base is sub-optimal and subject to a high risk of bias. Much existing evidence is derived from small scale studies that are limited by poor design and reporting, making it difficult to reliably judge how and in what circumstances social prescribing could deliver benefits. Few rigorous evaluations exist.
Those that do have so far failed to demonstrate improved health and wellbeing for service users, but suggest that finding ways to improve access and engagement with services may lead to better overall outcomes.
We know that engagement in community assets can improve health and well-being. However, we do not know how people become engaged with community assets and if the link worker model will encourage engagement and or enhance access and equity
With national policy implementation underway across the UK, there is now a need to understand the impact of social prescribing link worker services and how they can be developed in the future.
How are we doing it?
Over the three year (2022 to 2025) research award, we will employ a multi-region mixed methods approach to map current provision and service configuration and to assess whether access, engagement and outcomes vary by delivery model, geography and population characteristics over time. Our approach can be broken down into six areas of focus:
- WP 1: Implementation - to establish the key features and variations in delivery models for link worker social prescribing services within and between each region.
- WP 2: Access and equity - to assess inequalities in access, uptake and engagement based on area-level and population characteristics (age, gender, ethnicity, area deprivation, availability of community assets, and rurality).
- WP 3: Experience and acceptability - to understand experience and acceptability of the referral process, the therapeutic encounter and the process of accessing and engaging with social prescribing services from a range of perspectives.
- WP 4: Health and wellbeing and service outcomes - to assess health and wellbeing and service outcomes, and whether outcomes vary within and between services delivered and by population characteristics (age, gender, ethnicity, area deprivation, availability of community assets, and rurality).
- WP 5: Economic sustainability - to explore the value and economic sustainability of link workers in primary care
- WP 6: Dissemination and knowledge mobilisation - to ensure relevance to policy need and to maximise the impact and use of findings in decision-making processes as they occur.
The research team:
- Paul Wilson (Principle Investigator, WP1 & WP6 Lead)
- Dr. Luke Munford (Co-applicant, WP2 Lead & WP4 Co-lead)
- Prof. Matt Sutton (Co-applicant & WP5 Lead)
- Prof. Caroline Sanders (Co-applicant & WP3 Co-lead)
- Prof. John Wildman (Co-applicant & WP4 Co-lead)
- Prof. Kate O'Donnell (Co-applicant & WP3 Co-lead)
- Prof. Sally Wyke (Co-applicant & WP3 Co-lead)
- Prof. Stewart Mercer (Co-applicant)
- Prof. Chris Salisbury (Co-applicant)
- Dr. Hugh McLeod (Co-applicant)
- Prof. Eileen Kaner (Co-applicant)
- Charlotte Leonhardsen (Co-applicant)
- Claire Stevens (Co-applicant)
- Hugh Evans (Co-applicant)
- Liam Gilfellon (Co-applicant)
Who we are working with:
- NIHR Applied Research Collaboration North East and North Cumbria
- NIHR Applied Research Collaboration West
- NHS Greater Glasgow and Clyde
- NHS Lothian
- NHS Greater Manchester Integrated Care
- University of Glasgow
- University of Edinburgh
- Voluntary Health Scotland
- Bristol City Council
- Mental Health Concern
- Has the national rollout of social prescribing link workers in primary care been achieved? by Dr Anna Wilding (published September 2023)
This study/project is funded by the National Institute for Health and Care Research (NIHR) Health Service and Delivery Research Programme (HS&DR), NIHR134066.
The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.
Senior Programme Lead