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Social prescribing: integrating GP & community assets for health

Social prescribing: integrating GP and community assets for health

Social prescribing: integrating GP and community assets for health (Shine Award)

Start Date:  June 2014   End Date:  Sept 2015   Status: Completed

Background:

Our current health system is based on restoring people to good health, where treatment takes place in hospitals, is delivered by specialised doctors and nurses, and the patient often plays a passive role (Horne et al, 2013). Whilst this model is still extremely relevant, growing social inequalities and the increase in long term conditions call for a different approach (Brandling and House 2007).

Social prescribing is an attempt to systematically build a health pathway that makes use of community organisations as assets for the delivery of health and well-being interventions where patients have the opportunity to express their health concerns to a coordinator and decide the type of activity in the community they want to be referred to. The project involved 23 GP surgeries in City and Hackney who referred patients facing isolation, the elderly, and people with diabetes type 2 to a coordinator who met and assess patients' needs and jointly drew a plan involving the use of services delivered by community organisations within the borough.

This study measured a range of outcomes (wellbeing, anxiety/depression and social integration and support) for patients who attended social prescribing versus people with similar characteristics who attended standard care through their GP surgeries. Moreover, the study also evaluated the process of social prescribing by collecting opinions and views from patients with varied degree of participation in activities on the ground (qualitative in-depth interviews), by collecting reflections from coordinators (focus groups) and via events with stakeholders to capture the learning from the development of social prescribing. Finally, a cost-utility analysis was undertaken across the intervention and control areas.

This evaluation was carried out in close collaboration with the City and Hackney Clinical Commissioning Group and Queen Mary University (Blizzard Institute) which played a key part in both outcome and process evaluations, particularly in relation to data collection at baseline and follow up in intervention areas, some qualitative interviews with patients and observational work.

Aims: 

The aim of this study was to evaluate the process, outcome and cost-effectiveness of social prescribing for City and Hackney. In more detail the aims of the study were as follows:
  • Assess patients’ outcomes: general wellbeing (MYMOP2), anxiety and depression scale (HADS), social integration and support (HeiQ subscale) general health, and cost-effectiveness (EQ5D) at two different points in time, baseline and 8 months follow up.
  • Capture the learning from the process of development of SP in city and Hackney. This included interviews with key stakeholders providing a key space for them to reflect on their work, collect information about the programme from coordinators, and delivery organizations.
  • Document the experience of patients: (i) qualitatively interviewing patients with differential degrees of participation to the project.

Methods: 

This study measured a range of outcomes (wellbeing, self efficacy, quality of life, social engagement, and satisfaction) for patients who attended social prescribing versus people with similar characteristics who attended standard care in six GP control surgeries. Moreover, the study also evaluated the process of social prescribing by collecting opinions and views from patients with varied degree of participation in activities on the ground (qualitative in-depth interviews), by collecting reflections from coordinators (focus groups) and via events with stakeholders to capture the learning from the development of social prescribing. Finally, a cost analysis was undertaken across the intervention and control areas. 

Main Findings:

Impact: 

Social prescribing in City and Hackney was funded twice after the initial evaluation and it continues to be delivered, as for October 2016. The learning from the evaluation and steering group meetings has enabled the continuous improvements of the intervention.

A video capturing the impact of social prescribing in users is available here. https://youtu.be/PCxRLAM7wBQ

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Project Lead:

Dr Marcello Bertotti

Project team: Caroline Frostick, Dr Jin Tong, Prof Gopal Netuveli, Prof Gail Findlay, Prof Angela Harden

Funder: Health Foundation (Shine Award); City and Hackney Clinical Commissioning Group

Project Partners: Dr Patrick Hutt (City and Hackney Clinical Commissioning Group), Dr Dawn Carnes, Ratna Sohanpal, Rohini Mathur (Blizard Institute, Queen Mary), Dr Sally Hull (Clinical Effectiveness Group, Queen Mary)

Report: Social Prescribing Hackney Evaluation

For more information, contact: Dr Marcello Bertotti, 020 8223 4139; m.bertotti@uel.ac.uk

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