Will NHS social prescribing benefit patients in socially and economically disadvantaged settings? - A mixed-methods study of link worker interactions and networks

Research Question How do link workers create and sustain networks and relationships for social prescribing in socially and economically disadvantaged settings and how do these affect patient outcomes and experiences? Background Social prescribing (SP) is being implemented throughout primary care.

The success of SP relies on link workers (LW) being able to build relationships and connections with organisations in the community and with patients.

It is currently unclear whether or how SP operates high levels of socioeconomic disadvantage where community infrastructure may be limited and where patients may struggle to engage.

More research is needed to understand how SP operates in these areas and whether it will benefit patients experiencing socioeconomic disadvantage.

Aim To explore the level, nature, and process of LW interactions across organisations and understand the implication of SP processes for disadvantaged populations. To produce evidence-based recommendations to inform the equitable implementation of SP.

Objectives Conduct a meta-ethnography synthesising current literature and develop a conceptual framework to understand LWs' experiences of carrying out their role Interview LWs about their experiences of establishing networks between primary care and the voluntary and community sector for the delivery of social prescribing Explore and assess connections between LWs, primary care, and voluntary and community sector organisations for the delivery of SP in socioeconomically disadvantaged settings Explore and assess the interactions between LWs and patients experiencing socio-economic disadvantage Integrate findings to produce recommendations to support the equitable provision of SP and develop an initial framework for designing and evaluating a social prescribing intervention tailored to socioeconomically disadvantaged settings Methods I will conduct a mixed-methods study with three interlinked workstreams (WS).

WS1: A meta-ethnography to produce a conceptual model of LWs' experiences of SP.

This conceptual model will be further developed through interviews with 25 LWs to understand their experiences of building connections between primary care and community organisations in socioeconomically disadvantaged settings.

WS2: Mixed-methods case studies exploring the ways in which LWs establish relationships and networks for SP and the implications of these networks on patient outcomes. I will recruit five LWs as cases and up to eight patients per LW. Interviews, surveys, and observations will be used to collect data relating to LW interactions and patient experiences.

Social network analysis will be applied to measure and understand how LW networks and interactions shape patient outcomes. Follow-up data collection will take place after 6-9 months to observe changes in relationships and outcomes over time.

WS3: Findings will be brought together using triangulation and consultation with key stakeholders to produce recommendations and an initial framework to inform the development and evaluation of SP interventions tailored to socioeconomically disadvantaged settings.

Timelines: Year1: protocol developments; complete WS1 and begin WS2 Year2: WS2 Year 3: WS 3 - develop recommendations and an initial framework for the evaluation and development of SP interventions; dissemination.

Anticipated impact/dissemination Recommendations to support policy and increase the equitable provision and implementation of SP for patients will be disseminated using innovative approaches (e.g. RapidMooc videos and policy briefs) and through academic publications/presentations.