Community-enhanced social prescribing brings communities and link workers closer together to improve wellbeing for both individuals and communities.
Social prescribing is a way of connecting people with community groups and voluntary sector resources which may help to promote their wellbeing.
It involves a link worker, usually based in a GP surgery, meeting with someone who experiences low mood, anxiety or loneliness, for example. The link worker discusses their needs, interests and goals, and supports them to engage with appropriate activities, groups or resources in the local community. The aim of social prescribing is to provide a social and community-based alternative, or addition, to medication or psychological therapy.
The NHS Long-Term Plan aims to ensure all GP surgeries have access to social prescribing link workers. However, this national roll-out is not accompanied by a wealth of evidence of their effectiveness. It also largely neglects to address the issue of the capacity of communities to meet the increased demand for community-based wellbeing resources.
A new social prescribing model
To address these concerns, we developed a new model of community-enhanced social prescribing (CESP) which combines community engagement, organisational change and individual-level practice to improve both community and individual wellbeing. This is discussed in full in a paper we published in the International Journal of Community Wellbeing, but I will highlight some of the key features here.
CESP requires a literacy of community. Link workers need to understand what ‘community’ means to individuals – whether this relates to a geographical space, online communities or communities of interest, for example. They have a role to play in supporting the development of this community, rather than just facilitating referrals to community groups.
CESP broadens the focus from individual to community wellbeing. To do this it brings together two established models – Connected Communities and Connecting People. The former brings a community together to better understand its networks, assets and needs; the latter guides practitioners in how best to support people to develop connections with others in their community.
CESP starts with a panel of people from a neighbourhood, town or district. This ‘community panel’ use their local knowledge to pool information about groups, resources and networks people can use to enhance their wellbeing. This supplements knowledge about formal groups or local voluntary sector activities which is already publicly available. This information is shared with the local community via posters displayed in key locations such as GP surgeries or public noticeboards, and online in groups which people living locally access.
Link workers and local community, voluntary and statutory agencies engage with the panel to understand more about local informal resources which people can access. They use this knowledge to inform their work and identify unmet need. CESP works well when new resources are developed by the community, voluntary and statutory sectors working together to meet this need; benefitting both the wider community and those receiving support from a link worker.
The link workers use the Connecting People approach to support people to engage with community and voluntary sector groups and resources. This is an eight step approach to supporting people to develop their social networks. It starts with setting some goals and focuses on overcoming any barriers which may prevent someone stepping out to try something new. Throughout, the link worker engages with the community panel to keep their knowledge about the community up to date and to identify relevant resources for the people they support.
Evaluation
Together with colleagues at the University of Central Lancashire and the London School of Economics and Political Science, I have obtained funding from the NIHR Research for Social Care programme to evaluate the feasibility of CESP. We are working with Bluesci Social Prescribing Wellbeing Service to test whether it is possible to set it up and to evaluate it.
Bluesci employs Wellbeing Practitioners who undertake social prescribing on contract from the NHS. We are working with the team in Sale to set up a community panel and train the Wellbeing Practitioners in Connecting People. We will test the feasibility of CESP and its evaluation by using multiple methods:
- A controlled pre-post study of individuals receiving CESP (and those living in Salford not receiving it) to evaluate its indicative costs and outcomes
- Repeated cross-sectional community surveys in Sale and Salford to evaluate change in community wellbeing over the study period
- A process evaluation using in-depth qualitative interviews and evaluation of routinely collected data to assess the feasibility of CESP for Bluesci, its staff, users, volunteers and the local community.
There are many elements to the evaluation and we will have to wait until early in 2024 for the overall findings. However, I will post updates here throughout the project, so do keep an eye on this space for new developments. In the meantime, please take a look at the paper describing the CESP model for more information:
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