Creating a Tiered Leadership Framework for Social Prescribing Link Workers: A Multi- Methods Study

Background

Social prescribing connects individuals to community-based, non-clinical support to address wider determinants of health, such as loneliness, financial hardship, and social isolation. Social prescribing link workers (SPLWs) play a central role in delivering this model by providing holistic, person-centred support.

The SPLW workforce has expanded rapidly across England over recent years. Despite this, SPLWs work within non-standardised models across primary care, local authorities, and the voluntary and community sector. While their contribution is widely recognised, there are growing concerns about workforce sustainability, including high levels of stress, burnout, and turnover, as well as limited opportunities for career progression.

Leadership is an essential but underdeveloped component of the SPLW role. SPLWs are required to operate across multiple system levels: supporting individuals directly (micro level), influencing teams and organisations (meso level), and building partnerships across systems (macro level). Leadership expectations are often implicit, and existing leadership development opportunities are limited and not tailored to the complexity of the role.

Evidence suggests that current leadership models in health and care focus on traditional managerial approaches, which may not align with the relational, adaptive, and boundary-spanning leadership required in social prescribing. There is currently no agreed framework to guide leadership development for SPLWs, and limited evidence on what effective leadership looks like in this context.

This research will address this critical gap by examining leadership within the SPLW role, generating evidence and co-produced solutions to support leadership development across patient, organisational, and community levels.

Aims of the dphil

To explore the critical leadership skills and support required for effective practice among SPLWs and create a conceptual framework for leadership development that addresses identified barriers and facilitators at three levels: patient, organisational, and community.

What the research will entail

The research is structured into four work packages:

Work Package 1: a scoping review

To systematically identify, describe, and synthesise the global evidence on leadership development relevant to SPLWs and comparable community-based roles, assess how existing frameworks address leadership in practice, and highlight key gaps that remain.

Work Package 2: interviewing stakeholders

To generate an in-depth understanding of how SPLWs and key stakeholders experience and enact leadership across patient, organisational, and community settings, and to identify the key barriers and facilitators influencing leadership development and practice.

Work Package 3: Developing and validating a leadership framework

To develop a conceptual framework for leadership development for SPLWs, informed by evidence from the scoping review and qualitative research, and to validate its content and structure through a Delphi study with a range of stakeholders.

Work Package 4: Stakeholder-led solutions for implementation

• To explore how the leadership framework can be effectively implemented in real-world settings through participatory engagement with diverse stakeholders.
• To identify barriers and enablers to implementation across different contexts, including primary care, local authorities, and voluntary and community sector organisations.
• To co-produce practical, context-appropriate strategies and recommendations to support implementation, workforce development, and commissioning.
• To develop and refine outputs (e.g. implementation guidance, recommendations, and engagement insights) that support organisations in embedding leadership development for SPLWs in practice.

Who might benefit from this project

Service-user level:
Improved quality of care and support, with stronger relationships, trust, communication, and empowerment for individuals accessing social prescribing, particularly those with complex needs and from underserved groups.

Service level:
Improved leadership capability among SPLWs, leading to enhanced collaboration, clearer role understanding, improved workforce retention, and more effective service delivery across organisations.

Policy level:
Evidence-informed recommendations and a validated framework to guide workforce development, commissioning, and integration within health, care, and community systems.

Research/academic level:
Greater clarity on leadership in boundary-spanning roles, identification of key evidence gaps, and a foundation for future research on leadership, workforce development, and social prescribing.

Biography

I am a Consultant in Public Health at Haringey Council and a DPhil student at the University of Oxford focusing on social prescribing, leadership, and health inequalities. My academic background spans biochemistry, dentistry, dental public health, public health and global healthcare leadership, providing a multidisciplinary perspective on population health and systems change. My research explores leadership development for social prescribing link workers, aiming to strengthen workforce capability, support integrated care, and improve outcomes for communities through more effective, person-centred approaches.

Chantelle Fatania (0009-0007-3604-6595) - ORCID