Social prescribing and wellbeing promotion: how to ensure access to all?

Problem

The NHS has made social prescribing (SP) a priority. There is a discrepancy in SP definitions ranging from a primary care referral pathway to social and wellbeing interventions to community-empowerment strategies built on asset-based development. There is growing research suggesting a range of wellbeing and social interventions are effective. The recent 5 year GP forward view has advocated for new link workers in primary care to help navigate patients to the right practical support and wellbeing activities. However the evidence is scarce about what is the most acceptable, feasible and effective SP models in the UK. Questions also remain unanswered on whether these interventions are best linked to primary care or universal parallel interventions. This research project aims to understand which models of social prescribing linked to primary care are most acceptable, feasible and effective, and accessible to all, with a focus on the hard-to-reach populations. The hard to reach are defined as those who have difficulty in accessing services (due to language, cultural/ethnic, poverty, emotional or age barriers).

Approach

The approach over the next 2 years will consist of:Firstly, a set of narrative literature reviews including published and grey literature will be conducted to describe the characteristics and impact of: a/ the models for addressing access and availability of services for the hard-to-reach; b/ the psychological intervention models for helping people address their improvement in wellbeing and access to practical support; and c/ models to deliver social and wellbeing interventions.Secondly, in depth interviews and focus groups will be conducted with 15 patients from primary care (of which 7-8 will be from hard-to-reach populations), 15 health and wellbeing professionals (GPs, nurses, those conducting SP interventions) and 5 policy stakeholders. Questions will focus on people’s definition of social prescribing, on patients’ needs, perceived solutions and how acceptable they find their existing SP provision.Thirdly, between 8 to 10 social prescribing initiatives in the UK will be chosen to compare different approaches. These will be chosen purposively following the literature review and snowballing to cover different types of models: universal services for all and those targeted at the most vulnerable, health authority commissioned services vs local GP/social partnerships, and those linked exclusively to primary care and those that are not. These case studies will use both quantitative and qualitative methods to evaluate their effectiveness (clinical, social and financial), and describe their characteristics, their functioning and wider impact (observations and interviews).

Findings

Funding applications to conduct this research are underway.

Consequences

The findings of this research will allow a/ to better understand the accessibility and acceptability of SP interventions; b/ to assess the feasibility and effectiveness of interventions. This could guide further SP policy planning and SP initiatives on which models may be most appropriate.