Counting GP appointments when evaluating social prescribing: Does a reduction necessarily signal success?
In this blog, Stephanie Tierney considers GP usage as an outcome measure for social prescribing schemes.
For the current study we are conducting on the implementation of social prescribing link workers in primary care, we are trying to gather data on GP usage. Each site involved is asked to provide information on how often patients who have seen the link worker in the month we conducted fieldwork saw a GP in the a) six months prior, and b) six months after this month of fieldwork. Getting this information has been easier from some sites than others. We raised this issue with members of the advisory group for the study. This led to an interesting discussion about GP usage data as a metric of success for social prescribing. It was argued that rather than being medically centred, social prescribing is about linking people to support and activities in the community to assist with their broader health and well-being. Whilst this may result in them seeing their GP less, it was suggested that this should not be regarded as a primary goal. Instead, it was proposed that a focus should be on appropriate referrals – getting people to the right help at the right time. This may mean that someone goes to see their GP more, if the link worker picks up problems that require medical attention, or if the patient becomes activated to manage a long-term health condition and wants support with this from a medical professional. It was remarked that seeing a link worker may help with the quality of work health professionals can undertake with patients; better interactions may ensue because GPs know that social factors are being addressed by the link worker. These ideas concur with the findings from our realist review on the link worker role.
The link worker study mentioned in this blog is funded by a grant from the National Institute for Health and Care Research (NIHR130247). The views expressed are those of the author and not necessarily those of the NIHR, the Department of Health and Social Care or the author’s host institution.