Tierney, S. orcid.org/0000-0002-2155-2440, Westlake, D., Wong, G. et al. (10 more authors) (2025) Experiences of integrating social prescribing link workers into primary care in England — bolting on, fitting in, or belonging: a realist evaluation. British Journal of General Practice, 75 (752). e195-e202. ISSN 0960-1643
Abstract
Background
Following the 2019 NHS Long Term Plan, link workers have been employed across primary care in England to deliver social prescribing.
Aim
To understand and explain how the link worker role is being implemented in primary care in England.
Design and setting
This was a realist evaluation undertaken in England, focusing on link workers based in primary care.
Method
The study used focused ethnographies around seven link workers from different parts of England. As part of this, we interviewed 61 patients and 93 professionals from health care and the voluntary, community, and social enterprise sector. We reinterviewed 41 patients, seven link workers, and a link worker manager 9–12 months after their first interview.
Results
We developed four concepts from the codes developed during the project on the topic around how link workers are integrated (or not) within primary care: (or not) within primary care: centralising or diffusing power; forging an identity in general practice; demonstrating effect; and building a facilitative infrastructure. These concepts informed the development of a programme theory around a continuum of integration of link workers into primary care — from being ‘bolted on’ to existing provision, without much consideration, to ‘fitting in’, shaping what is delivered to be accommodating, through to ‘belonging’, whereby they are accepted as a legitimate source of support, making a valued contribution to patients’ broader wellbeing.
Conclusion
Social prescribing was introduced into primary care to promote greater attention to the full range of factors affecting patients’ health and wellbeing, beyond biomedicine. For that to happen, our analysis highlights the need for a whole-system approach to defining, delivering, and maintaining this new part of practice.
Metadata
Item Type: | Article |
---|---|
Authors/Creators: |
|
Copyright, Publisher and Additional Information: | © 2025The Authors. This article is Open Access: CC BY 4.0 licence (http://creativecommons.org/licences/by/4.0/). |
Keywords: | delivery of health care; link workers; primary health care; realist evaluation; social prescribing |
Dates: |
|
Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Medicine and Population Health |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 05 Mar 2025 16:38 |
Last Modified: | 05 Mar 2025 16:39 |
Status: | Published |
Publisher: | Royal College of General Practitioners |
Refereed: | Yes |
Identification Number: | 10.3399/bjgp.2024.0279 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:223975 |