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In July 2022, Stephanie Tierney, one of the researchers leading the study on social prescribing link workers’ role in primary care, met with an established PPI group in the north of England to talk about the project. This is a diverse group (e.g. in terms of age and ethnicity) formed of people with a range of life experiences. Here, Stephanie reflects on the feedback received from this group.

Our study PPI group is composed of committed and thoughtful individuals, whose views add richness to our understanding of the topic of social prescribing link workers in primary care. We have worked with them for about four years now; they initially supported us with a review that informed the current study. Members of this group continue to act as critical friends but have become relatively knowledgeable about social prescribing as a concept. Therefore, to complement our ongoing and valued discussions with the study PPI group, I took the opportunity to talk to people who had not worked with us previously on this topic of social prescribing. I visited a PPI group in the north of England. On the day, nine PPI contributors attended along with the group co-ordinator. We spent two hours together, discussing our research on the link worker role in primary care. Here are some of the key issues we covered:

  • Terminology: There was a preference within the group for the term ‘link worker’; it was felt that the term ‘social prescriber’ meant someone who just focused on social issues and encouraging people to socialise. It was also noted that there may be confusion among the public as the term ‘link worker’, in the past, has been used to refer to interpreters in the health service.
  • Knowledge: Some members of this group had heard of social prescribing before but there was a general sense that it was an unfamiliar idea to the public. It was felt that GP practices needed to do more to advertise its availability and purpose. It was suggested this could be done through a practice’s website and through any communication it had with patients (e.g. text messages, at the end of a recorded message that patients received when phoning up the surgery). It was stated that patients could be confused by the different roles that had appeared in primary care (e.g. link workers, health and well-being coaches, physician associates, advanced clinical practitioners). The question was raised about how link workers differed to community development workers – there was felt to be some overlap between these two roles in terms of advocacy and empowerment.
  • Referral: It was noted that if patients did not understand or know about the link worker role, they were unlikely to self-refer. It was suggested that some people might benefit from speaking to a link worker who did not go to see their GP because they were not interested in a ‘quick fix’ for their problems (e.g. tablets).
  • Follow up: Concern was expressed about who finds out what happens to a patient once they had seen a link worker (e.g. who supports someone to attend things in the community if necessary, who checks if the patient has benefitted from trying things in the community). It was felt that this sort of information was needed to understand if referral to a link worker had been helpful. The issue was also raised about how link workers empowered people rather than creating dependency.
  • Education/training of link workers: A standardised approach was called for, with a set curriculum, to ensure that patients received a similar standard of support and so that link workers felt able to carry out their job effectively. It was suggested that if link workers were able to achieve some formal qualifications in their job it could increase their satisfaction with the post and make them feel valued.
  • Barriers: Key barriers to patients engaging with a link worker raised by the group included: 

    Language (e.g. if English is not someone’s first language)
    Culturally inappropriate community services
    Lack of confidence to try things
    Lack of awareness of social prescribing – from healthcare professionals and patients
    Finances for community services/groups and for people to use these assets to support their health and well-being (e.g. paying for transport or to take part in activities if there is a charge)
    Link workers coming from a different background to people they are supporting

I plan to attend another meeting with this group next year, to report on some of the findings we are developing from the research.

The 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.