The social cure of social prescribing: a mixed-methods study on the benefits of social connectedness on quality and effectiveness of care provision

Kellezi, B. ORCID: 0000-0003-4825-3624, Wakefield, J.R.H. ORCID: 0000-0001-9155-9683, Stevenson, C. ORCID: 0000-0002-2438-6425, McNamara, N. ORCID: 0000-0003-3123-3678, Mair, E. ORCID: 0000-0001-5356-5927, Bowe, M. ORCID: 0000-0002-0491-1472, Wilson, I. ORCID: 0000-0001-6670-9328 and Halder, M.M. ORCID: 0000-0002-1608-6027, 2019. The social cure of social prescribing: a mixed-methods study on the benefits of social connectedness on quality and effectiveness of care provision. BMJ Open, 9 (11): e033137. ISSN 2044-6055

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Objectives: To assess the degree to which the ‘Social Cure’ model of psycho-social health captures the understandings and experiences of healthcare staff and patients in a Social Prescribing (SP) pathway and the degree to which these psycho-social processes predict the effect of the pathway on healthcare usage.

Design: Mixed-method: Study 1: semi-structured interviews, Study 2: longitudinal survey.

Setting: An English SP pathway delivered between 2017 and 2019.

Participants: Study 1: GPs (n=7), healthcare providers (n=9) and service users (n=19). Study 2: 630 patients engaging with SP pathway at a four-month follow-up after initial referral assessment.

Intervention: Chronically ill patients experiencing loneliness referred onto SP pathway and meeting with a Health Coach and/or Link Worker, with possible further referral to existing or newly-created relevant third-sector groups.

Main Outcome Measure: Study 1: Health providers and users’ qualitative perspectives on the experience of the pathway and social determinants of health. Study 2: Patients’ primary care usage.

Results: Healthcare providers recognised the importance of social factors in determining patient well-being, and reason for presentation at primary care. They viewed SP as a potentially effective solution to such problems. Patients valued the different social relationships they created through the SP pathway, including those with link workers, groups, and community. Group memberships quantitatively predicted primary care usage, and this was mediated by increases in community belonging, and reduced loneliness.

Conclusions: Methodological triangulation offers robust conclusions that ‘Social Cure’ processes explain the efficacy of SP, which can reduce primary care usage through increasing social connectedness (group membership and community belonging) and reducing loneliness. Recommendations for integrating Social Cure processes into SP initiatives are discussed.

Strengths and limitations of this study

The strengths of this study:
a. It identifies mechanisms that underlie effective Social Prescribing interventions.
b. It identifies mechanisms that enable more appropriate use of primary care services.
c. It reports the most comprehensive multi-perspective evaluation of an NHS model of Social Prescribing to date, with accounts from General Practitioners, Link Workers, Health Coaches and Patients.

The limitations of this study:
a. The results observed in our longitudinal analysis are short-term and are likely to develop further over longer time-periods, though observing benefits after such a short time is promising.
b. The specific characteristics of this sample (adults with complex health needs from across the socio-economic spectrum, living in a relatively affluent area) need to be borne in mind when considering the applicability of SP to other populations.

Item Type: Journal article
Publication Title: BMJ Open
Creators: Kellezi, B., Wakefield, J.R.H., Stevenson, C., McNamara, N., Mair, E., Bowe, M., Wilson, I. and Halder, M.M.
Publisher: BMJ Group
Date: 14 November 2019
Volume: 9
Number: 11
ISSN: 2044-6055
Rights: This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:
Divisions: Schools > School of Social Sciences
Record created by: Jonathan Gallacher
Date Added: 28 Oct 2019 15:03
Last Modified: 20 Jun 2023 14:55

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