What does it mean for link workers to fit or belong in primary care? Reflections on a conference presentation
6 April 2023
At the end of March 2023, Stephanie Tierney presented some early learning from the study she co-leads with Kamal Mahtani on implementing link workers into primary care. This presentation was given at the British Journal of General Practice Research Conference. She was joined by Debra Westlake who has played a key role in collecting and analysing data. Here, Stephanie reflects on what was discussed.
As I stepped off the train at Euston station, I was back in London for the first time since lockdown three years earlier. It was a strange experience, preparing to present in-person again (rather than on screen). It felt like a good opportunity to get back into doing this, at a conference that seemed welcoming and well planned. I was relieved that my presentation was scheduled before lunch, allowing me to enjoy the spread that was laid on for those attending (something you don’t get when part of a virtual conference).
I was pleased to be able to talk about ideas coming from our analysis of data collected as part of the study. My presentation centred on the difference between link workers feeling like they have to fit into a primary care setting and culture, rather than sensing that their role had been considered and embraced as a vehicle for thinking more broadly about health (away from an overly medicalised perspective).
Our data have highlighted that some link workers experience a lack of preparation for how they will function in a specific practice; they are left to plot their own way to delivering social prescribing and, as a consequence, can feel overwhelmed and alone. In other cases, there is some attempt by a practice to integrate the link worker into primary care but without a clear understanding or appreciation of the role and its contribution to patients’ well-being. This can mean that link workers are asked to do things outside of their remit (e.g. in terms of patients and problems they support). Belonging involves clear and ongoing planning around the role. It calls for negotiation and good communication between those employing link workers and these members of staff to ensure that patients can benefit from social prescribing.
The presentation resulted in some interesting questions and discussion on the following topics:
- The different experience of the role for link workers in rural areas – especially the potential for a lack of services or support to connect patients to in non-urban areas.
- The type of patients link workers can assist – particularly supporting people with specific mental health conditions, and how the offer of social prescribing may not be made available to this group.
- The extent to which link workers are providing a therapeutic rather than a connecting service – this led to a conversation about how far link workers are able to address issues that may be more structural in nature (e.g. due to socio-economic inequalities, limited opportunities for employment, lack of educational support, poor public transport infrastructure).
- The optimum place for link workers to meet with patients – seeing them in a GP practice may help with de-medicalising problems that doctors are often consulted about (e.g. pain) that can have underlying psychosocial components, but could also mean that patients are in a setting (a clinical room) where they feel uncomfortable talking about the various challenges they are facing in life.
Presenting to an audience in the same physical space brought an energy to proceedings that can be missing when speaking remotely via a computer screen. It was encouraging to see people’s immediate responses to what was being said through their non-verbal gestures. I also think that being together in a room with others allowed for a wider range of topics to be considered.
Conversations had at this conference session will help as we prepare a paper on the topic of link workers fitting or belonging in primary care, which we hope to submit to a journal in the autumn.
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.
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28 February 2023
In this blog, we reflect on a meeting with our patient-public involvement (PPI) group and link workers. At the meeting, we talked about and got those attending to reflect on some of the data we have collected for the research we are conducting on the implementation of link worker roles in primary care.
8 March 2023
In recognition of Social Prescribing Day (on 9th March 2023), Stephanie Tierney and Kamal Mahtani have taken time to reflect, within this blog, on the burgeoning portfolio of projects they have developed that relate to this approach to managing non-medical factors affecting people’s health and well-being.