Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK.
North East Ambulance Service NHS Foundation Trust, Newcastle upon Tyne, UK.
Health Soc Care Community. 2021 May;29(3):654-663. doi: 10.1111/hsc.13337. Epub 2021 Mar 11.
There is a sustained increase in demand for emergency and urgent care services in England. The NHS Long Term Plan aims to reduce the burden on emergency hospital services through changing how pre-hospital care operates, including increased delivery of urgent care. Given the recognised potential of social prescribing to address wider determinants of health and reduce costs in other settings, this study aimed to understand the role that social prescribing can play in pre-hospital emergency and urgent care from the perspectives of staff. Semi-structured interviews (n = 15) and a focus group (n = 3) were conducted with clinical staff (n = 14) and non-clinical health advisors (n = 4) from an English Ambulance Service covering emergency (999) and non-emergency (111) calls. Data were analysed using a pre-defined framework: awareness of social prescribing; potential cohorts suitable for social prescribing; and determinants of social prescribing. Awareness and knowledge of social prescribing was limited, though when social prescribing was explained to participants they almost universally recognised its benefits for their role. Social prescribing was considered to be most beneficial to those calling for reasons relating to mental health, loneliness or social isolation, in particular older people and frequent users of 999 and 111 services. Determinants of social prescribing were identified across the micro (patient and staff acceptability of social prescribing), meso (triage and referral pathways) and macro (commissioning and funding) levels of analysis. This is the first empirical study to explore social prescribing in pre-hospital emergency and urgent care services, which suggests that it has potential to improve quality of care at the point of people accessing these services. There is a pressing need to address the micro, macro and meso level determinants identified within this study, in order to support staff within pre-hospital emergency and urgent care services to socially prescribe.
英格兰对紧急和紧急护理服务的需求持续增长。NHS 长期计划旨在通过改变院前护理的运作方式来减轻急诊医院服务的负担，包括增加紧急护理的提供。鉴于社会处方在解决更广泛的健康决定因素和降低其他环境成本方面的潜在作用，本研究旨在从工作人员的角度了解社会处方在院前紧急和紧急护理中的作用。对来自覆盖紧急（999）和非紧急（111）电话的英格兰救护服务的临床工作人员（n=14）和非临床健康顾问（n=4）进行了半结构化访谈（n=15）和焦点小组（n=3）。使用预定义的框架对数据进行了分析：社会处方的认识；适合社会处方的潜在队列；以及社会处方的决定因素。对社会处方的认识和了解有限，但当向参与者解释社会处方时，他们几乎普遍认识到其对其角色的好处。社会处方被认为对那些因心理健康、孤独或社会隔离等原因拨打 999 和 111 服务电话的人最有益，特别是老年人和 999 和 111 服务的频繁使用者。在微观层面（患者和员工对社会处方的可接受性）、中观层面（分类和转诊途径）和宏观层面（委托和资金）分析层面确定了社会处方的决定因素。这是第一项探索院前紧急和紧急护理服务中社会处方的实证研究，这表明它有可能改善人们获得这些服务时的护理质量。迫切需要解决本研究中确定的微观、宏观和中观层面的决定因素，以支持院前紧急和紧急护理服务中的工作人员进行社会处方。
