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Background:

Social prescribing supports people with problems that are not necessarily physical but can affect how they feel; things like loneliness, money worries and housing difficulties. Link workers help to deliver social prescribing in GP practices and elsewhere (e.g. community settings). They do this by assisting people to identify their ‘non-medical’ needs. They can then connect individuals to resources or activities in their local area that might help to address these needs (e.g. social groups, organisations that give advice on housing or debt, cultural activities). In the NHS in England, primary care has received funding to employ link workers. How the link worker role is set up and carried out varies across the country, and it is evolving in response to contextual changes such as the COVID-19 pandemic. We wanted to develop an in-depth understanding of the role to generate evidence-based recommendations on how to optimise the implementation of link workers in primary care. We were awarded funding from the National Institute for Health Research to explore this topic.

Research question:

When implementing link workers in primary care to sustain outcomes – what works, for whom, why and in what circumstances?

Study design: A realist evaluation, composed of two work packages (WPs), will be undertaken. It will build on a programme theory we developed from a previous realist review.

  • WP1 will explore the implementation of link workers in different settings. A purposive sample of 6 cases (link workers) within 6 sites (geographical areas) across England will be selected. Each case site will be examined in-depth for 3 months. Data collection will be in-person and remote (via Microsoft Teams or telephone). It will involve talking to link workers and people they work with (GPs, practice mangers, voluntary-community sector staff) and to patients.
  • WP2 will consist of follow-up semi-structured interviews with patients from WP1. These interviews will take place 9-12 months after the initial interview. The interviews will seek to understand how patients benefitted (or not) from seeing a link worker in the longer term.

Sample:

There will be approximately 102 participants involved across the 6 sites; 60 patients and 42 other participants (link workers, healthcare professionals and voluntary-community sector staff).

Study duration:

The study will run for 30 months. It starts in August 2021.

Key contacts:

Please contact one of the study leads for further information:

This research is funded by the National Institute for Health Research (HS&DR Project: NIHR130247).

Blog posts

The Impact of COVID-19 on social prescribing link workers’ experiences in primary care – key messages from an evaluation in the southwest of England.

In this blog, researcher, Debra Westlake, reflects on a previous evaluation she conducted between 2020 and 2021 with a team at the University of Plymouth, investigated the impact of COVID-19 on social prescribing in the southwest of England.

The Link Worker Project - Reflections from a PPI Contributor

PPI contributor, Bernard, reflects on the role of link workers, having been involved in one of our core Social Prescribing projects, seeking to better understand implementation of link workers in primary care.

Street-level bureaucrats: Ideas from Lipsky applied to the role of social prescribing link workers

In this blog, Stephanie Tierney, Senior Researcher and Departmental Lecturer, Centre for Evidence-Based Medicine, University of Oxford, shares details of the latest study that aims to explore and explain the link worker role in primary care, and highlights the concept of 'Street-Level Bureaucracy', proposed by Michael Lipsky to better understand this role.

Observing the social prescribing link worker role: reflections from the front line

Researcher, Debra Westlake, reflects on the first stages of data collection from latest social prescribing study; exploring and comparing the roles of links workers at various GP surgeries throughout the UK, in sustaining outcomes in primary care.

Understanding the implementation of link workers in primary care: A realist evaluation to inform current and future policy

A new study, led by CEBM members, Dr Stephanie Tierney and Associate Professor Kamal Mahtani, aims to understand the link worker role in primary care as part of social prescribing (in particular, to identify what works, for whom, why and in what circumstances). In this blog, the team shares details about this research, which has been funded by the National Institute for Health Research (NIHR).