Social Prescribing – an overview
Social Prescribing entails linking individuals from primary care (often their GP) to social interventions, with the potential to improve health and wellbeing. This pathway expands available options to clinicians whose patients have complex social and medical needs, by connecting them to community resources, information and social activities, as well a range of statutory and non-statutory agencies.
Potentially, social prescriptions can enable healthcare professionals to respond more effectively to a range of non-clinical needs and connect patients with professionals who are able to provide longer consultations and more detailed knowledge of local social activities.
The range of activities is diverse and can include gardening programmes, books on prescription, exercise on referral, referral for debt counselling, or housing advice. The range is such that the mechanisms of action are also diverse and can be activated through being with people, cognitive stimulation, or identity generation. In this way, social prescriptions are potentially applicable for treating a broad range of conditions or their prevention.
The practice of social prescribing is growing in popularity, but delivery is also disparate, variable and complex. A variety of referral models exist, ranging from signposting by primary care practitioners through to iterative activity choices, facilitated by link workers who can meet at length with patients and collate available activities to suit need and lifestyle, as well as provide a point of ongoing contact. There are myriad ways in which this process can be disrupted; for example if staff are not aware or unsupportive of the idea, or patients are unable to initiate their particular social prescription, it is impossible to maximise the potential of the service, ensure appropriate use, and avoid wasting resources.
There is then a risk of social prescribing services being developed without evidence about what should be offered or the processes that are required to support them. A disconnect between health and other services might result in patients not getting a social prescription appropriate to their needs. Our research programme seeks to generate robust evidence about what works, for whom, and in what ways.
The PenCLAHRC team have worked in collaboration with Volunteer Cornwall, the AHSN, Cornwall Public Health and the Wolseley Trust, to develop successful bids for funding to deliver new social prescription schemes in Plymouth and Cornwall. Grants have been awarded by the Department for Health and Social Care to include an allocation for evaluation work, conducted by a Researcher in Residence, alongside delivery of the schemes.
This evaluation work will take the form of a ‘researcher-in-residence’, who will help understand what works best, collect robust quantitative and qualitative data, and help services refine delivery throughout the programme.
During the early stages activity will centre around getting the researcher-in-residence embedded within the organisations and beginning data collection. There are plans to hold a regional meeting to share learning in the near future.
The programme will run across the two sites in Plymouth and Cornwall for 2 years from early 2019, generating detailed reports and events to discuss and champion social prescribing in the South West.
As this project is in its infancy, we plan to spend the next few months engaging the stakeholders, meeting participants and delivery partners and beginning data exploration and collection.
- A review of the health impacts of gardening: https://www.sciencedirect.com/science/article/pii/S0378512217311064
- BJGP: https://bjgp.org/content/69/678/6
- BMJ Opinion: https://blogs.bmj.com/bmj/2017/07/18/social-prescribing-offers-huge-potential-but-requires-a-nuanced-evidence-base/
- Maturitas: https://www.maturitas.org/article/S0378-5122(17)31106-4/abstract
- Protocol paper: https://systematicreviewsjournal.biomedcentral.com/articles/10.1186/s13643-016-0269-6/
- Lancet conference proceedings from the RR: https://www.sciencedirect.com/science/article/pii/S0140673617329975
- Cochrane review of environmental enhancement activity: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD010351.pub2/information