Intervention development for community-based self-referred social prescribing
Lead Research Organisation:
Plymouth University
Department Name: Peninsula Medical School
Abstract
Social prescribing is not new, but has gained popularity and significant political, policy, and health service traction in recent years. Each new Primary Care Network will receive funding for at least one additional social prescribing worker. There is a growing evidence base, however much of the focus has been on health-service models, mostly through primary care. This is a good starting point but focuses heavily on interventions to help recovery rather than prevention. Additionally, whilst much is known about how these pathways function, little is understood about how the community (and VCS) who are delivering activities are impacted by these new referrals.
As a team with extensive expertise in delivering, researching, and being part of social prescribing, we feel there is an opportunity to develop a more formal pathway into existing community-based social prescribing activities, which we know have health and wellbeing effects, but without the heavy reliance on the health service 'scaffolding'.
In this project we will use a structured approach to design a future programme of community-referred social prescribing suitable for individuals to use and access community assets for their health. We will bring together a broad range of stakeholders with experience of designing, delivering and - most importantly - accessing social prescribing, to collect information about self-referrals in the community. We want to understand how the systems work, how these structures interact and how to best support them to offer activities in the best way for individuals to attend and improve their health. We also want to explore how the coming expansion will affect those already delivering programmes.
We will produce guidance for this whole systems approach to social prescribing, including a detailed system map and programme theory for the proposed pathway and interventions. We will use our existing contacts, as well as those from people we work with for this project, to make sure our guidance reaches those in a position to benefit from it, and to influence service changes for the good of communities. We will then seek further funding to test whether this guidance works using primary data.
As a team with extensive expertise in delivering, researching, and being part of social prescribing, we feel there is an opportunity to develop a more formal pathway into existing community-based social prescribing activities, which we know have health and wellbeing effects, but without the heavy reliance on the health service 'scaffolding'.
In this project we will use a structured approach to design a future programme of community-referred social prescribing suitable for individuals to use and access community assets for their health. We will bring together a broad range of stakeholders with experience of designing, delivering and - most importantly - accessing social prescribing, to collect information about self-referrals in the community. We want to understand how the systems work, how these structures interact and how to best support them to offer activities in the best way for individuals to attend and improve their health. We also want to explore how the coming expansion will affect those already delivering programmes.
We will produce guidance for this whole systems approach to social prescribing, including a detailed system map and programme theory for the proposed pathway and interventions. We will use our existing contacts, as well as those from people we work with for this project, to make sure our guidance reaches those in a position to benefit from it, and to influence service changes for the good of communities. We will then seek further funding to test whether this guidance works using primary data.
Technical Summary
The linking of individuals to social interventions outside of NHS healthcare for health and wellbeing, social prescribing or SP, is the current zeitgeist in UK health policy. There is a financial commitment for every GP practice to have access to a SP link-worker by 2023 and there are 1,000 more SP staff being recruited as of early 2020. Most current literature relates to primary-care focused programmes and, we feel there an opportunity to work with stakeholders to develop a formal route for self-referrals into community-based activities for health. This would reduce the use of the health service "scaffolding" and help to build healthier populations through prevention.
We will use an intervention development methodology informed by systems science. We are partnering with SIPHER (Systems Science in Public Health and Health Economics Research), to develop social prescribing system maps. We will generate a detailed understanding of how SP currently works alongside qualitative insight into what works in terms of connecting people to the services they need.
We propose two phases. Firstly, evidence synthesis building on our previous work to map provision. Secondly, consultation meetings and focus groups to establish current pathways and activities, as well as different contexts. We will aim to better understand the ways in which systems are currently brought together and the barriers to pathways from the individual perspective.
We will bring this work together through the development of a detailed systems map explicating the core relationships. We will also provide programme theory describing the relationships between the actors, systems and resources needed, and surfacing the underlying assumptions and contexts in which pathways can operate best.
Together, these will form the basis for guidance for a whole systems approach to social prescribing and our next step will be to seek funding to test the systems map and pathways developed here using primary data.
We will use an intervention development methodology informed by systems science. We are partnering with SIPHER (Systems Science in Public Health and Health Economics Research), to develop social prescribing system maps. We will generate a detailed understanding of how SP currently works alongside qualitative insight into what works in terms of connecting people to the services they need.
We propose two phases. Firstly, evidence synthesis building on our previous work to map provision. Secondly, consultation meetings and focus groups to establish current pathways and activities, as well as different contexts. We will aim to better understand the ways in which systems are currently brought together and the barriers to pathways from the individual perspective.
We will bring this work together through the development of a detailed systems map explicating the core relationships. We will also provide programme theory describing the relationships between the actors, systems and resources needed, and surfacing the underlying assumptions and contexts in which pathways can operate best.
Together, these will form the basis for guidance for a whole systems approach to social prescribing and our next step will be to seek funding to test the systems map and pathways developed here using primary data.
Planned Impact
We will work with stakeholders and partners in an iterative process where experiences are shared, relative success in different contexts clarified and analysis used to co-create guidance for social prescribing through community referrals and a detailed system map; which can then be tested in a future project.
Those involved in the delivery and those involved in the research of these pathways and interventions are part of the project team (CT, LC, RB), and work closely with the organisations core to social prescribing (voluntary sector, commissioning, local authorities). We aim to become a point of contact for evidence relating to these programmes.
The team also has strong connections with relevant practitioner groups: RB is a GP with links to local and national primary care groups; a number of applicants are PenARC researchers with links across the South West health research sector; and KH has extensive connections with social prescribing groups through the ongoing programme, including the Cornwall Social Prescribing Network, the SW Regional Social Prescribing Network as well as the Academic Health Sciences South West's new community of practice network for new models of care. We are working with NHSE and the Westminster-based Social Prescribing Network to make sure our project is informed by, and relevant to these national networks with an interest in social prescribing.
It is well known that interest and intent around social prescribing is increasing rapidly, however there is still little robust evidence around how and in what ways these should be offered. Even less is known about SP which is less reliant on the health service and which therefore has a greater public health/prevention focus. The output of this project is whole system guidance for community referred social prescriptions; this will be circulated around our applied health research, clinical, practice, and voluntary sector networks. We will make this accessible to the public, who are potential end users of social prescribing (e.g. providing a summary of findings in job centres, libraries, Age UK offices)
We will also use traditional publication, presentation at scientific conferences, and dissemination through professional organisations. As a project under the PenARC, we will use the extensive patient, practitioner, commissioning and other stakeholder groups already engaged as well as hosting a project page including outputs and links on the PenARC website. We can also use the National SP Network, University of Plymouth, Exeter and PenARC email distribution lists for broader reach.
A key part of the proposed project is acceptability work to be undertaken for the new pathway specification and map. It will then be tested in a future study which would be disseminated through high profile publication, presentation and media engagement. Given the collective networks and skills of the applicants, we would be well placed to ensure the subsequent pathway/intervention was communicated to policy makers, commissioners, and service delivery organisations, should it be found to be effective and cost-effective.
Those involved in the delivery and those involved in the research of these pathways and interventions are part of the project team (CT, LC, RB), and work closely with the organisations core to social prescribing (voluntary sector, commissioning, local authorities). We aim to become a point of contact for evidence relating to these programmes.
The team also has strong connections with relevant practitioner groups: RB is a GP with links to local and national primary care groups; a number of applicants are PenARC researchers with links across the South West health research sector; and KH has extensive connections with social prescribing groups through the ongoing programme, including the Cornwall Social Prescribing Network, the SW Regional Social Prescribing Network as well as the Academic Health Sciences South West's new community of practice network for new models of care. We are working with NHSE and the Westminster-based Social Prescribing Network to make sure our project is informed by, and relevant to these national networks with an interest in social prescribing.
It is well known that interest and intent around social prescribing is increasing rapidly, however there is still little robust evidence around how and in what ways these should be offered. Even less is known about SP which is less reliant on the health service and which therefore has a greater public health/prevention focus. The output of this project is whole system guidance for community referred social prescriptions; this will be circulated around our applied health research, clinical, practice, and voluntary sector networks. We will make this accessible to the public, who are potential end users of social prescribing (e.g. providing a summary of findings in job centres, libraries, Age UK offices)
We will also use traditional publication, presentation at scientific conferences, and dissemination through professional organisations. As a project under the PenARC, we will use the extensive patient, practitioner, commissioning and other stakeholder groups already engaged as well as hosting a project page including outputs and links on the PenARC website. We can also use the National SP Network, University of Plymouth, Exeter and PenARC email distribution lists for broader reach.
A key part of the proposed project is acceptability work to be undertaken for the new pathway specification and map. It will then be tested in a future study which would be disseminated through high profile publication, presentation and media engagement. Given the collective networks and skills of the applicants, we would be well placed to ensure the subsequent pathway/intervention was communicated to policy makers, commissioners, and service delivery organisations, should it be found to be effective and cost-effective.