Social prescribing: A new medicine?

2016 ◽  
Vol 10 (2) ◽  
pp. 90-95 ◽  
Author(s):  
Patrick Hutt
Keyword(s):  
Social Support ◽  
Primary Care ◽  
General Practice ◽  
Health System ◽  
Local Community ◽  
Evidence Base ◽  
Community Services ◽  
Social Prescribing

The concept behind social prescribing is to link patients in primary care with local community services. Social prescribing is increasingly being championed as a key component of a GP’s therapeutic toolkit; it was referenced in the General Practice Forward View 2016 as an example of providing social support for patients and integrating care across the wider health system. This article sets out to describe what constitutes social prescribing, to highlight examples of services that exist, and to discuss the existing evidence base for social prescribing.

scholarly journals Use and impact of social prescribing: a mixed-methods feasibility study protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e037681
Author(s):  
Anant Jani ◽  
Harshana Liyanage ◽  
Uy Hoang ◽  
Lucy Moore ◽  
Filipa Ferreira ◽  
...  
Keyword(s):  
Primary Care ◽  
Mixed Methods ◽  
Data Extraction ◽  
Evidence Base ◽  
Advisory Group ◽  
Framework Analysis ◽  
Sentinel Network ◽  
Social Prescribing ◽  
Study Results ◽  
The Impact

IntroductionSocial prescribing aims to address social determinants of health, which account for 80%–90% of health outcomes, but the evidence base behind it is limited due to a lack of data linkingsocial prescribing activity and outcomes.Methods and analysisThe objective of the quantitative component of this feasibility studyisto identify the characteristics of individuals who receive social prescriptions and describe the use and estimate the impact of social prescribing; the latter will be done on a homeless subgroup. We will use the Oxford Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) primary care sentinel network, whose general practicescover a population of over 4 000 000 patients. Social prescribing data will be extracted onall recorded patients for 5 years up to 31 January 2020. The objective for the qualitative component of the study isto explore approaches to understand the contextual factors that will have influenced our quantitative findings to identify mechanisms to encourage adoption of social prescribing in primary care while improving data quality. Itwill comprise up to three 90–120 minute advisory group meetings for six to eight participants. Participants will be recruited based on their experience of delivering primary care within Oxfordshire and Surrey. The advisory group outputs will be analysed using framework analysis and will be used to create a survey instrument consisting of statements that surveyees, who will consist of primary care practitioners within the RCGP RSC, can agree or disagree with.Ethics and disseminationAll RCGP RSC data are pseudonymised at the point of data extraction. No personally identifiable data are required for this investigation. This protocol follows the Good Reporting of a Mixed Methods Study checklist. The study results will be published in a peer-reviewed journal and the dataset will be available to other researchers.

scholarly journals Preparing the prescription: a review of the aim and measurement of social referral programmes

BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e017734 ◽  
Author(s):  
Emily S Rempel ◽  
Emma N Wilson ◽  
Hannah Durrant ◽  
Julie Barnett
Keyword(s):  
Literature Review ◽  
Local Community ◽  
Grey Literature ◽  
Cost Savings ◽  
Well Being ◽  
Community Services ◽  
Emergency Case ◽  
Social Prescribing ◽  
Online Databases ◽  
Individual Measure

ObjectiveOur aim is to review, and qualitatively evaluate, the aims and measures of social referral programmes. Our first objective is to identify the aims of social referral initiatives. Our second objective is to identify the measures used to evaluate whether the aims of social referral were met.DesignLiterature review.BackgroundSocial referral programmes, also called social prescribing and emergency case referral, link primary and secondary healthcare with community services, often under the guise of decreasing health system costs.MethodFollowing the PRISMA guidelines, we undertook a literature review to address that aim. We searched in five academic online databases and in one online non-academic search engine, including both academic and grey literature, for articles referring to ‘social prescribing’ or ‘community referral’.ResultsWe identified 41 relevant articles and reports. After extracting the aims, measures and type of study, we found that most social referral programmes aimed to address a wide variety of system and individual health problems. This included cost savings, resource reallocation and improved mental, physical and social well-being. Across the 41 studies and reports, there were 154 different kinds of measures or methods of evaluation identified. Of these, the most commonly used individual measure was the Warwick-Edinburgh Mental Well-being Scale, used in nine studies and reports.ConclusionsThese inconsistencies in aims and measures used pose serious problems when social prescribing and other referral programmes are often advertised as a solution to health services-budgeting constraints, as well as a range of chronic mental and physical health conditions. We recommend researchers and local community organisers alike to critically evaluate for whom, where and why their social referral programmes ‘work’.

scholarly journals Tensions and opportunities in social prescribing. developing a framework to facilitate its implementation and evaluation in primary care: a realist review

BJGP Open ◽  
2021 ◽  
pp. BJGPO.2021.0017
Author(s):  
Sara Calderón-Larrañaga ◽  
Yasmin Milner ◽  
Megan Clinch ◽  
Trisha Greenhalgh ◽  
Sarah Finer
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Best Practice ◽  
Grey Literature ◽  
Good Practice ◽  
Realist Review ◽  
Individual Characteristics ◽  
Quantitative Evidence ◽  
Social Prescribing ◽  
Community Sector

BackgroundSocial prescribing (SP) involves linking patients in primary care with services provided by the voluntary and community sector. Despite growing interest within NHS primary care, it remains unclear how and under what circumstances SP might contribute to good practice.AimTo define ‘good’ practice in SP by identifying context-specific enablers and tensions. To contribute to the development of an evidence-based framework for theorizing and evaluating SP within primary care.Design and settingRealist review of secondary data from primary care-based SP schemes.MethodWe searched for qualitative and quantitative evidence from academic articles and grey literature following the Realist and Meta-narrative Evidence Syntheses-Evolving Standards (RAMESES). We characterised common SP practices in three settings (general practice, link workers and community sector) using archetypes which ranged from best to worst practice.ResultsA total of 140 studies were included for analysis. We characterised common SP practices in three settings (general practice, link workers and community sector) using archetypes which ranged from best to worst practice. We identified resources influencing the type and potential impact of SP practices and outlined four dimensions in which opportunities for good practice arise: 1) individual characteristics (stakeholder’s buy-in, vocation, knowledge); 2) interpersonal relations (trustful, bidirectional, informed, supportive, transparent and convenient interactions within and across sectors); 3) organisational contingencies (the availability of a predisposed practice culture, leadership, training opportunities, supervision, information governance, resource adequacy and continuity and accessibility of care within organisations); and 4) policy structures (bottom-up and coherent policymaking, stable funding and suitable monitoring strategies). Findings where synthesised in a multi-level, dynamic and usable SP Framework.ConclusionOur realist review and resulting framework revealed that SP is not inherently advantageous. Specific individual, interpersonal, organisational and policy resources are needed to ensure SP best practice in primary care.

scholarly journals New horizons in supporting older people's health and wellbeing: is social prescribing a way forward?

2020 ◽  
Vol 49 (3) ◽  
pp. 319-326 ◽  
Author(s):  
Kate Hamilton-West ◽  
Alisoun Milne ◽  
Sarah Hotham
Keyword(s):  
Mental Health ◽  
Local Community ◽  
Local Level ◽  
National Policy ◽  
Evidence Base ◽  
Poor Mental Health ◽  
Care Needs ◽  
Health And Wellbeing ◽  
Social Prescribing ◽  
Age Related

Abstract Older people’s health and care needs are changing. Increasing numbers live with the combined effects of age-related chronic illness or disability, social isolation and/or poor mental health. Social prescribing has potential to benefit older people by helping those with social, emotional or practical needs to access relevant services and resources within the local community. However, researchers have highlighted limitations with the existing evidence-base, while clinicians express concerns about the quality of onward referral services, liability and upfront investment required. The current article provides a critical review of evidence on social prescribing, drawing on the RE-AIM Framework (Glasgow et al., 1999) to identify questions that will need to be addressed in order to inform both the design and delivery of services and the evolving research agenda around social prescribing. We emphasise the need for researchers and planners to work together to develop a more robust evidence-base, advancing understanding of the impacts of social prescribing (on individuals, services and communities), factors associated with variation in outcomes and strategies needed to implement effective and sustainable programmes. We also call on policymakers to recognise the need for investment in allied initiatives to address barriers to engagement in social prescribing programmes, provide targeted support for carers and improve access to older adult mental health services. We conclude that social prescribing has potential to support older people’s health and wellbeing, but this potential will only be realised through strategic alignment of research, local level implementation and national policy and investment.

Primary care networks: an opportunity to improve community wound care

2020 ◽  
Vol 25 (3) ◽  
pp. S20-S25
Author(s):  
Liam Benison
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Health Services ◽  
Health System ◽  
Community Health ◽  
Patient Outcomes ◽  
Wound Care ◽  
Community Health Services ◽  
Predominant Role ◽  
Poor Outcomes

Primary care networks (PCNs) were introduced in England in 2019 to bring about closer collaboration between general practice and community health services. The ambition is that greater collaboration between services will achieve better patient outcomes and reduce costs through more effective sharing of staff and resources. Wound care might be considered an ideal focus for PCNs, since general practice and community health services not only have a predominant role in the management of wounds, but variable and suboptimal practice continues and poor outcomes persist. This article investigates some ways in which PCNs might enable health-system changes that could improve the provision of wound care.

scholarly journals A realist evaluation of social prescribing: an exploration into the context and mechanisms underpinning a pathway linking primary care with the voluntary sector

2017 ◽  
Vol 19 (03) ◽  
pp. 232-245 ◽  
Author(s):  
Marcello Bertotti ◽  
Caroline Frostick ◽  
Patrick Hutt ◽  
Ratna Sohanpal ◽  
Dawn Carnes
Keyword(s):  
Primary Care ◽  
Health Inequalities ◽  
Contextual Factors ◽  
Community Services ◽  
Realist Evaluation ◽  
Health Interventions ◽  
Long Term Conditions ◽  
Realist Approach ◽  
Social Prescribing ◽  
The Social

This article adopts a realist approach to evaluate a social prescribing pilot in the areas of Hackney and City in London (United Kingdom). It unpacks the contextual factors and mechanisms that influenced the development of this pilot for the benefits of GPs, commissioners and practitioners, and reflects on the realist approach to evaluation as a tool for the evaluation of health interventions. Primary care faces considerable challenges including the increase in long-term conditions, GP consultation rates, and widening health inequalities. With its emphasis on linking primary care to non-clinical community services via a social prescribing coordinator (SPC), some models of social prescribing could contribute to reduce the burden on primary care, tackle health inequalities and encourage people to make greater use of non-clinical forms of support. This realist analysis was based on qualitative interviews with users, commissioners, a GP survey, focus groups and learning events to explore stakeholders’ experience. To enable a detailed analysis, we adapted the realist approach by subdividing the social prescribing pathway into stages, each with contextual factors, mechanisms and outcomes. SPCs were pivotal to the effective functioning of the social prescribing service and responsible for the activation and initial beneficial impact on users. Although social prescribing shows significant potential for the benefit of patients and primary care, several challenges need to be considered and overcome, including ‘buy in’ from some GPs, branding, and funding for the third sector in a context where social care cuts are severely affecting the delivery of health care. With its emphasis on context and mechanisms, the realist evaluation approach is useful in understanding how to identify and improve health interventions, and analyse in greater detail the contribution of different stakeholders. As the SPC is central to social prescribing, more needs to be done to understand their role conceptually and practically.

scholarly journals The impact of social prescribing services on service users: a systematic review of the evidence

2019 ◽  
Vol 30 (4) ◽  
pp. 664-673 ◽  
Author(s):  
Julia V Pescheny ◽  
Gurch Randhawa ◽  
Yannis Pappas
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Grey Literature ◽  
Evidence Base ◽  
Service Users ◽  
Health And Wellbeing ◽  
Medical Needs ◽  
Social Prescribing ◽  
Health And Social Care ◽  
The Impact

Abstract Background Social prescribing initiatives are widely implemented in the UK National Health Service to integrate health and social care. Social prescribing is a service in primary care that links patients with non-medical needs to sources of support provided by the community and voluntary sector to help improve their health and wellbeing. Such programmes usually include navigators, who work with referred patients and issue onward referrals to sources of non-medical support. This systematic review aimed to assess the evidence of service user outcomes of social prescribing programmes based on primary care and involving navigators. Methods We searched 11 databases, the grey literature, and the reference lists of relevant studies to identify the available evidence on the impact of social prescribing on service users. Searches were limited to literature written in English. No date restrictions were applied, and searches were conducted to June 2018. Findings were synthesized narratively, employing thematic analysis. The Mixed Methods Appraisal Tool Version 2011 was used to evaluate the methodological quality of included studies. Results Sixteen studies met the inclusion criteria. The evidence base is mixed, some studies found improvements in health and wellbeing, health-related behaviours, self-concepts, feelings, social contacts and day-to-day functioning post-social prescribing, whereas others have not. The review also shows that the evaluation methodologies utilized were variable in quality. Conclusion In order to assess the success of social prescribing services, more high quality and comparable evaluations need to be conducted in the future. International Prospective Register of Systematic Reviews number: CRD42017079664

scholarly journals 293 Improving the Quality of Dementia Care in General Practice: A Qualitative Study

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii1-iii16
Author(s):  
Meghan Bourque ◽  
Tony Foley
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Chronic Disease ◽  
Disease Management ◽  
Chronic Disease Management ◽  
Community Services ◽  
Dementia Care ◽  
Community Based ◽  
Data Set

Abstract Background The prevalence of dementia in Ireland is rising. General Practitioners (GPs) play a central role in caring for people with dementia. There is a growing demand for community-based care, emphasized by the Irish National Dementia Strategy (INDS). The INDS advocates a multidisciplinary, community-based approach to dementia care. However, there is a paucity of research exploring GPs’ views on dementia since publication of the INDS. The aim of the study is to develop a deeper understanding of how to improve the quality of dementia care in General Practice from the perspective of Irish GPs. Methods Semi-structured interviews were conducted with GPs. GPs who completed a continuing professional development module in Cork on dementia in primary care were purposively recruited. Interviews were analyzed thematically. Analysis was iterative and ongoing with data collection. Results 12 (34.3%) GPs agreed to participate. 10 interviews have been conducted to-date. Participants were evenly distributed by sex (5 male, 5 female). Experience in General Practice varied (3-32 years). Most GPs practiced in mixed urban-rural settings (n=8) and had nursing home commitments (n=7). The average interview length was approximately 45 minutes. Three major themes emerged from the data set: factors promoting care in current practice; resistance to care; and recommendations to improve care. Continuity of care, early disease recognition, coding, audit, and coordinated care teams were recognized as factors promoting quality care. Time, funding, access to secondary care, and inadequate community resources hindered care. GPs emphasized the need for coordinated community services, GP education, review of the chronic disease management scheme for GPs, and service standardization in order to improve care. Conclusion GPs find dementia care to be a complex, challenging aspect of primary care. While education and training is advocated by GPs, service delivery also needs to be reconfigured. Dementia needs to be included under chronic disease management in Ireland and services must become standardized.

scholarly journals The challenges of integrating signposting into general practice: qualitative stakeholder perspectives on care navigation and social prescribing in primary care

2021 ◽  
Author(s):  
Lisa Brunton ◽  
Abigail Tazzyman ◽  
Jane Ferguson ◽  
Damian Hodgson ◽  
Pauline A Nelson
Keyword(s):  
Primary Care ◽  
General Practice ◽  
National Policy ◽  
Professional Services ◽  
Structured Interviews ◽  
Practice Staff ◽  
Social Prescribing ◽  
Stakeholder Perspectives ◽  
Wide Range ◽  
The Right

Abstract Background A national policy focus in England to address general practice workforce issues has led to a commitment to employ significant numbers of non-GP roles to redistribute workload. This paper focuses on two such roles: the care navigation (CN) and social prescribing link worker (SPLW) roles, which both aim to introduce ‘active signposting’ into primary care, to direct patients to the right professional/services at the right time and free up GP time. There is a lack of research exploring staff views of how these roles are being planned and operationalised into general practice and how signposting is being integrated into primary care. Methods The design uses in-depth qualitative methods to explore a wide range of stakeholder staff views. We generated a purposive sample of 34 respondents who took part in 17 semi-structured interviews and one focus group (service leads, role holders and host general practice staff). We analysed data using a Template Analysis approach. Results Three key themes highlight the challenges of operationalising signposting into general practice: 1) Role perception – signposting was made challenging by the way both roles were perceived by others (e.g. among the public, patients and general practice staff) and highlighted inherent tensions in the expressed aims of the policy of active signposting.; 2) Role preparedness – a lack of training meant that some receptionist staff felt unprepared to take on the CN role as expected and raised patient safety issues; for SPLW staff, training affected the consistency of service offer across an area; 3) Integration and co-ordination of roles – a lack of planning and co-ordination across components of the health and care system challenged the success of integrating signposting into general practice. Conclusions This study provides new insights from staff stakeholder perspectives into the challenges of integrating signposting into general practice, and highlights key factors affecting the success of signposting in practice. Clarity of role purpose and remit (including resolving tensions inherent the dual aims of ‘active signposting’), appropriate training and skill development for role holders and adequate communication and engagement between stakeholders/partnership working across services, are required to enable successful integration of signposting into general practice.

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