Implementation and impact of a social prescribing intervention: an ethnographic exploration

Tessa M. Pollard · Kate Gibson · Bethan Griffith · Jayne M. Jeffries · Suzanne M Moffatt

27 citations0/0 files storedBritish Journal of General Practice

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Art Therapy and Mental Health Evaluation and Performance Assessment Health Policy Implementation Science

Abstract

BACKGROUND: Social prescribing involves referral of patients from primary care to link workers, who work with them to access appropriate local voluntary and community sector services. AIM: To explore how a social prescribing intervention was delivered by link workers and the experiences of those referred to the intervention. DESIGN AND SETTING: The study used ethnographic methods to conduct a process evaluation of a social prescribing intervention delivered to support those living with long-term conditions in an economically deprived urban area of the North of England. METHOD: Participant observation, shadowing, interviews, and focus groups were used to examine the experiences and practices of 20 link workers and 19 clients over a period of 19 months. RESULTS: Social prescribing provided significant help for some people living with long-term health conditions. However, link workers experienced challenges in embedding social prescribing in an established primary care and voluntary sector landscape. The organisations providing social prescribing drew on broader social discourses emphasising personal responsibility for health, which encouraged a drift towards an approach that emphasised empowerment for lifestyle change more than intensive support. Pressures to complete assessments, required for funding, also encouraged a drift to this lighter-touch approach. A focus on individual responsibility was helpful for some clients but had limited capacity to improve the circumstances or health of those living in the most disadvantaged circumstances. CONCLUSION: Careful consideration of how social prescribing is implemented within primary care is required if it is to provide the support needed by those living in disadvantaged circumstances.

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References

1977Outline of a Theory of Practice 2020Health equity in England: the Marmot review 10 years on 2000Data analysis in qualitative research 2000Diabetes prevalence and socioeconomic status: a population based study showing increased prevalence of type 2 diabetes mellitus in deprived areas 2018Social prescribing: where is the evidence?2018Social Prescribing in the U.S. and England: Emerging Interventions to Address Patients’ Social Needs 2019Service-users’ perspectives of link worker social prescribing: a qualitative follow-up study 2021Social prescribing and classed inequality: A journey of upward health mobility?

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2024What does social prescribing look like in practice? A qualitative case study informed by practice theory 2025Social prescribing for people living with long-term health conditions: a scoping review 2025The Role of Social Prescribing Interventions in Addressing Health Inequalities in the United Kingdom: A Narrative Review 2024Building common understanding: seeking consensus and defining social prescribing across contexts – a collective commentary on a Delphi study

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