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In this blog, researcher Steven Markham describes how he and colleagues from the University of Oxford facilitated a knowledge exchange event on a study exploring the implementation of link workers in primary care.

Knowledge Exchange

Knowledge exchange is a process which brings together researchers, users of research, and wider groups and communities to exchange ideas, evidence and expertise. As we approach the end of the study exploring the implementation of link workers in primary care, we are holding a series of knowledge exchange events across England. The first of these was held in Birmingham in September 2023. This two-day knowledge exchange event was arranged to disseminate learning from our study and to get feedback on what we have learnt from the project.

Open Session

The event started with a two-hour session that was open to anyone interested in the study. It was attended, mainly, by those involved in delivering social prescribing. Stephanie Tierney opened by introducing the study and what had led to the research being funded and supported. This was followed with a presentation by Debra Westlake on the concept of Holding. ‘Holding’ refers to link workers enacting four roles: supporting patients while they wait for access to services, sustaining patients as they prepare for change, sharing the emotional burden experienced by other healthcare professionals, and bearing witness to patient distress. Holding appears to be a vital, but often overlooked, aspect of social prescribing work for patients who are experiencing multiple concerns and may have reached a ‘tipping point’.


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Delegates were invited to discuss the consequences of holding for link workers, patients, healthcare professionals and the voluntary and community sector. These fruitful discussions were followed by a presentation about Discretion. Stephanie Tierney introduced ‘discretion’ as an individual’s freedom to choose what is done or how to behave. In terms of social prescribing services, discretion is often exercised within the boundaries of primary care and operates within existing services link workers are able to connect patients to. Link workers might have discretion on what patient conditions they support and to what degree they engage in holding patients. They might also apply discretion in the mode of service delivery (e.g. where link workers see patients and what feedback they provide, to whom). Delegates discussed some of the ways they do and do not have discretion in their roles. As we have found in our research, link worker discretion varies greatly across England.

This session ended with an opportunity for those attending to reflect on what we had spoken about in terms of the research findings. We received positive feedback that the ideas raised by the research team resonated with people’s experiences of and brought to the surface issues that occur with social prescribing.

Part two of the first day

The second part of this knowledge exchange event involved a small group of link workers, who had been invited in advance to discuss key ideas coming from the study. I facilitated a ‘getting to know each other’ exercise. It involved inviting those present to describe what motivated them to become a link worker. It allowed us to learn more about social prescribing services across the country.

These link workers were encouraged to share what might make social prescribing services unique and what they enjoyed about their role. Although there were fewer people present, there were rich conversations about social prescribing from the point of view of link workers and researchers. We ended the first day with a dinner and continued to discuss related topics throughout the evening.

Day 2 of the knowledge exchange event

Day 2 involved the same small group of link workers who had stayed after the open session from the day before. I introduced the group to some patient vignettes based on interviews we had conducted as part of the study exploring link workers’ implementation into primary care. The link workers read through seven vignettes. Then we held a very interesting discussion about key themes coming from the vignettes, what link workers found surprising in them, and what they said about benefits patients could encounter from social prescribing. During this activity, there was a lot of discussion around link workers’ experiences and the types of patients they supported.  

The final activity invited link workers to state how, if given the opportunity, they would like to set up a new link worker programme, and what it might involve in the short and long-term. This brought up some ideas link workers appreciated about their services and also gave them an opportunity to discuss areas for improvement or that would make their job easier and improve care for patients.

After a lovely lunch we returned to our respective areas of the country with fresh knowledge to share and new contacts. We would like to thank all of those who attended the knowledge exchange event for sharing their views and experiences, and for commenting on the research we are undertaking.


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.