An evaluation of the implementation and practice of social prescribing
AuthorsPescheny, Julia Vera
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AbstractIt is a current policy priority in the UK to break down the traditional divide between primary care and community services, in order to deliver continuous, integrated, and need-driven care and to provide opportunities for health professionals to respond to the wider determinants of health more effectively. Social prescribing is an example of an approach in primary care that promotes partnership working between the health and community and voluntary sector. It provides health professionals with a non-medical referral option to address the non-medical needs of patients, determining their health and wellbeing. Given that social prescribing is increasingly implemented across the UK, it is a key priority for commissioners and service providers to understand the implementation, uptake and adherence, and potential outcomes of social prescribing, as well as the existing evidence base. This study uses a mixed-methods design, reviewing previous evaluations on social prescribing to provide an overview of the evidence base. In addition, face-to-face semistructured interviews were conducted with health professionals, navigators, service providers, managers, and decision-makers to explore the facilitators and barriers to the implementation of the social prescribing programme in Luton. Face-to-face, semi-structured interviews were also held with service users of the Luton programme, to explore the factors affecting uptake and adherence to social prescribing, as well as the patient outcomes from a service user perspective. Lastly, secondary data from the Luton programme was reviewed, to analyse the change in energy expenditure and mental wellbeing for service users after the programme. The systematic literature review identified a range of service user outcomes and specific facilitators and barriers to the implementation of social prescribing, enabling increased and efficient access to available evidence. In addition, this study found that the implementation of the Luton programme was affected by operational processes, the evaluation process, communication, relationships, shared knowledge, and understanding among stakeholders, human resources, organisational readiness, and contextual factors. The uptake of social prescribing was affected by the trust in general practitioners, programme design, patient expectations, perceived need, and benefits, and fear of stigma of psychosocial problems. The support of navigators, the availability and accessibility of services, perceived benefits, and health and wellbeing of service users affected the adherence to the Luton programme. In addition, the study found that service users experienced improvements in their health related behaviours, mental wellbeing, and pain relief due to social prescribing. Lastly, the quantitative analysis showed that the Luton social prescribing programme has the potential to increase energy expenditure of participants and to activate sedentary patient groups. The iv analysis also found a statistically significant improvement in mental wellbeing postintervention. Findings of this study contribute to the development of an evidence base for social prescribing and can support policy-makers, decision-makers, and providers to improve the implementation, uptake, and adherence for social prescribing in the future. In addition, the identified gaps in the evidence base and the limitations of this study can inform future research in this field.
CitationPescheny, J.V. (2019) `An evaluation of the implementation and practice of social prescribing`. PhD thesis. University of Bedfordshire.
PublisherUniversity of Bedfordshire
TypeThesis or dissertation
DescriptionA thesis submitted to the University of Bedfordshire, in partial fulfilment of the requirements for the degree of doctor of Philosophy.
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