What is the role of the social prescribing link worker?

While an established role, the social prescribing link worker is still surrounded with questions – here’s more about the role, including how you can measure success within it

CREDIT: This is an edited version of an article that originally appeared on The Primary Care Network

The Primary Care Network hosted a webinar covering the role of the social prescriber featuring co-chair of the National Social Prescribing Network Sian Brand and Dr Marie Anne Essam where they covered social prescribing and personalised care in detail.

Even though the role is pretty established, they have repeatedly received lots of questions about the role from people who are struggling, so they wanted to share some of the key takeaways and provide a summary of what the role entails and the value the social prescribing link worker can add.

What is a social prescribing link worker?

Social prescribing, by definition, is a means of connecting people to community activities, groups, and services which offer practical social and emotional support to optimise the health and wellbeing of a patient and their families.

Working alongside GPs and other clinical leads, the link workers work hard to understand what does and doesn’t matter to the patient.

They are quite literally a link point between the patient, their practice, and those within the patient’s community (e.g. housing, social care, employer, mental health services.).
They are committed to joining everyone up and embedding a fully integrated approach to care, in order to achieve transformative change.

Why do we need this service?

It is estimated that between 25%-40% of medical appointments are linked to social reasons and not medical.

Social prescribing has been successful so far because patients are supported, via a system of signposting, to access a suite of services which can better meet their needs.

This means there is less pressure on primary care more widely as clinical appointments are freed up.

Skills and objectives

The ability to create trusting relationships and enable transformative conversations is the absolute bedrock of this role.

Alongside developing a detailed knowledge (and contacts list) of community and voluntary-based support services, link workers are trained in the following:

• Motivational interview
• Active listening
• Basic coaching skills

There is also a need to persuade and support the PCN to understand the differences between a more traditional pathogenic pathway (which tends to be medically inclined) and the newer social model, which is based on upskilling and educating people about how to look after themselves, where to access support outside of healthcare and reduce dependency on medical interventions.

How does the service align with the practice and the wider network?

Referrals in

Some GP practices still believe that the referral should be made internally; however, one of the aims of social prescribing is to reduce pressure on GP consultation times.

Instead, referrals could be made via self-referral, through the ambulance, voluntary sector, DWP, or library, and not restricted to healthcare providers.

The establishment of a range of referral points should ensure early intervention to either prevent further progression to, or the requirement for, medical assistance, and / or complement any ongoing medical treatments.

The consultation

The value of social prescribing is that a personalised care approach is offered.

The amount of time or appointment a link worker spends offers every individual varies on the level of need to achieve the valued change.

The development of a standardised practice or network model requires dedication and input from multiple parties within the practice or network.

Also consider the inclusion of the link worker within any MDT meetings, particularly where more complex patients are concerned.

Joining up with community and voluntary sector services

One of the main components of the role is maintaining and updating a core list of contacts for predominantly charitable organisations and local voluntary groups but also establishing relationships with commissioned services such as drug and alcohol services, mental health support providers and wider health and social care teams.

Day-to-day support for the link worker

• Ensure there is a system of supervision for the link worker, including dedicated time with an allocated clinical lead to discuss any concerns, gaps in services and / or complex cases
• Encourage sharing of best practices amongst peers
• Provision of regular and up to date training is a must; particularly within all the usual key areas such as safeguarding, to allow for timely review where improvement may be required
• Support link workers to develop stakeholder relationships (where required) to help them navigate the network and neighbourhood teams, and so that they can enhance their scope of practice
  

Measuring success

There are a number of ways a practice or network can measure the success of the service and here are a few we’d recommend:

• The PCN and ICB should choose a particular outcome measure which they can consistently and regularly be able to evidence.

For example, the number of medical appointments freed up can be measured by doing a basic internal audit of link worker activity versus number of clinical appointments.

If there is an elevated number of social prescribing appointments and a reduced number of clinical appointments, this clearly demonstrates a positive impact.

In relation to the above, good data is always crucial in measuring performance however within this context, this would directly fulfil the NHS England requirement to benchmark workforce investment by 2024.

It’s an oldie but a goodie but implementation of a patient satisfaction survey is always a solid way of measuring how well a service is performing.

Produce and publish a case study! There is nothing more inspirational (or convincing) than a well-documented personal journey of success.