In this blog, researcher Steven Markham describes how he and the wider link worker implementation study team are making sense of the vast amount of data produced from seven case studies.
Monthly analysis meetings
Our study on the link worker role in primary care has generated a lot of data about this complex intervention and so we meet weekly to discuss project progress and findings across research sites. We also meet each month online and come together for in-person meetings every 2-3 months to talk about the broader concepts being developed through the analysis. When we meet online, we take turns to present information and make decisions on the types of findings to focus on. These meetings are always productive. However, it is beneficial to meet in person for many reasons. In terms of sharing ideas and working through problems, it can be easier to have these discussions face-to-face; we often draw diagrams together and work with post-it notes to think in a tactile way about the data. Face-to-face meetings also aid our working relationship, as we are geographically spread across England.
Our latest discussions
In February (2023) the two principle investigators, Stephanie Tierney and Kamal Mahtani, met with realist methods expert Geoff Wong and researchers responsible for generating and analysing data. Prior to this, we met face-to-face in December 2022. Researchers left this meeting in December with the task of thinking about boundaries and use of discretion related to many aspects of social prescribing and the link worker role. We each agreed to focus on concepts from our initial analysis of the data and considered what boundaries and discretionary factors were at play in influencing a series of established outcomes, including:
- Patient health and well-being
- Link worker retention
- The extra capacity link workers add to primary care
When we re-convened in February, we shared some of our findings and started to draw ways to visually represent concepts and considerations around the implementation of link workers.
We discussed factors that Primary Care Networks (PCN) need to make decisions on, and the degrees of discretion that might be applied to each decision. For example, how many times a patient can see a link worker could be as few as one or two sessions or could be unlimited. These, as with any choices, are dependent on contextual factors, such as the types of issues the patient is facing and the types of service or interventions the link worker is able to offer. If there are few social interventions that link workers can refer to, they may be more likely to provide an intervention themselves (supporting the patient through regular phone calls). This links to a previous blog on: who creates the interventions that social prescribing link workers refer to and what social programmes are appropriate for whom.
By the end of this February meeting, we decided to focus on several aspects of the link worker role and how much discretion could be exercised around these: being bound by strict guidelines or having the volition, for example, to make appointment duration and frequency tailorable to patient needs. We look forward to sharing our representations of these aspects in future publications.
Steven is working on a study that 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.
What to read next
Who creates the interventions that social prescribing link workers refer to and what social programmes are appropriate for whom?
17 October 2022
In this blog, Steven Markham, research fellow at the Centre for Evidence-Based Medicine, University of Oxford, reflects on experiences of designing health promotion interventions to inform current and future policy.
Counting GP appointments when evaluating social prescribing: Does a reduction necessarily signal success?
13 December 2022
In this blog, Stephanie Tierney considers GP usage as an outcome measure for social prescribing schemes.