Ayorinde Abimbola, Grove Amy, Ghosh Iman, Harlock Jenny, Meehan Edward, Tyldesley-Marshall Natalie, Briggs Adam, Clarke Aileen, Al-Khudairy Lena
Division of Health Sciences, University of Warwick, Coventry, UK.
Monash University, Melbourne, VIC, Australia.
J Health Serv Res Policy. 2024 Apr;29(2):111-121. doi: 10.1177/13558196231212854. Epub 2023 Dec 15.
Despite significant investment in social prescribing in England over the last decade, we still do not know if it works, or how models of social prescribing fit within wider health and care policy and practice. This study explores current service delivery structures and assesses the feasibility of a national evaluation of the link worker model.
Semi-structured interviews were conducted between May and September 2020, with 25 key informants from across social prescribing services in England. Participants included link workers, voluntary, community and social enterprise staff, and those involved in policy and decision-making for social prescribing services. Interview and workshop transcripts were analysed thematically, adopting a framework approach.
We found differences in how services are provided, including by individual link workers, and between organisations and regions. Standards, referral pathways, reporting, and monitoring structures differ or are lacking in voluntary services as compared to clinical services. People can self-refer to a link worker or be referred by a third party, but the lack of standardised processes generated confusion in both public and professional perceptions of the link worker model. We identified challenges in determining the appropriate outcomes and outcome measures needed to assess the impact of the link worker model.
The current varied service delivery structures in England poses major challenges for a national impact evaluation. Any future rigorous evaluation needs to be underpinned with national standardised outcomes and process measures which promote uniform data collection.
尽管在过去十年里英国对社会处方投入了大量资金，但我们仍不清楚其是否有效，也不清楚社会处方模式如何融入更广泛的健康和护理政策及实践。本研究探讨了当前的服务提供结构，并评估了对联络专员模式进行全国性评估的可行性。
2020年5月至9月期间，对来自英国社会处方服务领域的25名关键信息提供者进行了半结构化访谈。参与者包括联络专员、志愿、社区和社会企业工作人员，以及参与社会处方服务政策制定和决策的人员。采用框架分析法对访谈和研讨会记录进行了主题分析。
我们发现服务提供方式存在差异，包括个体联络专员的服务方式，以及不同组织和地区之间的差异。与临床服务相比，志愿服务在标准、转诊途径、报告和监测结构方面存在差异或缺失。人们可以自行转诊给联络专员或由第三方转诊，但缺乏标准化流程导致公众和专业人士对联络专员模式的认知产生困惑。我们确定了在确定评估联络专员模式影响所需的适当结果和结果指标方面存在的挑战。
英国目前多样的服务提供结构给全国性影响评估带来了重大挑战。未来任何严格的评估都需要以促进统一数据收集的国家标准化结果和流程措施为基础。
