XGBSHN5023 Personalised Care And Social Prescribing Assignment Sample

Introduction - Personalised Care And Social Prescribing Assignment Sample

Social prescribing can be defined as a concept that has been operated in modern healthcare systems referring to the process of referring clients to community resources (Husk et al., 2019). Different from other curative approaches in the medical sphere, such as the diagnosis and treatment model, social prescribing recognises social factors that affect individuals such as loneliness or lack of financial stability and mental health. It allows healthcare professionals to recommend the patient to non-health-related services and activities such as group meetings, exercises, and community services thus culminating in the patient-centered medicine practice (Ahluwalia, Spicer, & Storey, 2020).

This literature review evaluates the literature for indications of the efficacy and suitability of the social prescribing interventions. It examines whether these interventions have improved the existing condition of health and reviews the evaluation techniques utilised for its determination. Despite these sources’ promises of positive effects such as better mental health, reduced loneliness, and increased social connection (Foster et al., 2021), there are concerns as to how these remain valid when it comes to the current populations and contexts.

This review will also discuss the effectiveness of planning and evaluation methods of social prescribing that focus on qualitative, quantitative, and mixed-method approaches. Thus, this review offers a critique of the way social prescribing is being practiced and addressed in the current healthcare system having analysed the existing literature data.

Discussion

The Evidence Base for the Effectiveness and Appropriateness of Social Prescribing Interventions on Individuals' Health and Well-being

Social prescribing is an innovative method in the framework of the person-centered approach in healthcare to address the root causes of health-related factors. It enables the patient to signpost to community groups like exercise classes, social support, and art activities since such factors have a positive impact on the health of the patient. Some benefits and the suitability of social prescribing interventions have been noted in different studies carried out.

Improvements in Mental Health and Well-being

Another advantage that researchers identify with social prescribing is the improvement of the mental well-being of individuals (Husk et al., 2019). In a consecutive study from Wakefield et al., (2022), the authors had undertaken a longitudinal investigation on the health benefits of social connectedness within a social prescribing pathway. It has been established that their involvement in community activities helped in decreasing loneliness and increasing self-rated quality of life measurement. Similarly, Foster et al. (2021) established that patients who participated in the social prescribing programs addressed in this paper reported a decrease in anxiety and depression hence an improvement in mental well-being. These studies indicate that social prescription could be useful in managing mental health issues in a more holistic approach other than the prescription of drugs.

However, there are some criticisms of social prescribing for turning out to be helpful in mental health care. According to some researchers, there are initial signs that such advantages will manifest themselves in the long-term persistency, and the durability of these benefits is questionable. For instance, a systematic review by Nowak & Mulligan (2021) described fluctuations in the positive mental health results, such that some participants relocated to social isolation once their involvement with the intervention was over. This has led to issues on whether social prescribing entails a long-term solution or if perhaps sustained support is required to sustain the changes that social prescribing brings.

Impact on Physical Health Outcomes

Besides mental health, the result of social prescribing also reveals the health improvement associated with the physical health platform. Structured behaviours such as these walking groups or gardening intervention programmes have been associated with increased physical activity which is vital in patients with chronic ailments like diabetes and cardiovascular diseases (McCormack et al., 2021). Also, participation in community-based activities connects with a decreased number of emergency hospitalizations and visits to primary care, which may mean that social prescribing decreases healthcare demands (Ahluwalia, Spicer, & Storey, 2020).

Still, it is stressed that there is not enough evidence regarding the positive impact of social prescribing on physical health. Data three is self-reported since the participants are very keen to answer the questions honestly; however, this kind of data is often influenced by bias. There is also a scarcity of randomized controlled trials (RCTs) that would offer stronger evidence of causal relationships between social prescribing interventions and enhanced physical health outcomes (Hopkins et al., 2023). This underscores the importance of conducting large-scale studies in the hope of effectively establishing the role that the mechanism of social prescribing has on an individual’s physical health in the long run.

Addressing Social Isolation and Community Engagement

Community referral is one of the critical aspects that central tenets of social prescribing focus on improving social inclusion. As identified by Wakefield et al. (2022), it has been established that engaging in community-based activities fosters support frames, which are useful for especially elderly people and persons with chronic illnesses. The National Academy for Social Prescribing (NASP) also recognise the feature of social prescribing as the key to the improvement of the community’s capacity by linking the people to other community assets and reducing their reliance on clinical services (Socialprescribingacademy, 2024).

However, the use of social prescribing interventions is subject to certain social and economic factors. The following are some of the barriers that can restrict an individual’s practice of undertaking prescribed activities: transportation, financial barriers, and exclusion from technology use (Foster et al., 2021). Additionally, it also requires paid resources endorsed and supported by the local authorities and charities that are not well funded. Thus, in organisation, social prescribing may not have significant impacts on health in areas where such services are still rudimentary (Hopkins et al., 2023).

Variability in Implementation and Delivery

Thus, even the degree of social prescribing differs depending on how it is being practiced. In the UK, to enhance the service provision, the NHS has employed social prescribing link workers to help in referring people and also to assist them in accessing them. Though there is a lot of appreciation for this particular model due to its more comprehensive nature, challenges persist in achieving consistent service delivery. It can be noted that different healthcare sectors may deliver social prescribing in rather different ways and therefore the experiences and subsequent results can differ significantly (Ahluwalia et al., 2020).

Furthermore, it is necessary to note the importance of linking workers’ training and experience in the social prescribing process. Kiely et al. (2021) indicate that high-quality link worker officers who would offer more personalized encouragement can improve appointment attendance and completion of set tasks. However, there might be some discrepancies in training as well as inadequate funding, which impairs the quality of the services delivered at some regional centers (Nowak & Mulligan, 2021).

In general, analysed literature indicates that social prescribing can be a useful and suitable approach that may have a positive impact on an individual’s health and well-being, especially in the presence of mental health issues and social exclusion. There are thus concerns about the longevity of the impacts, the solidity of the physical health gains, and the heterogeneity of the service provision. Further research especially high-quality RCTs needs to be conducted to confirm its effectiveness.

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The Evidence Base for the Effectiveness of Social Prescribing Intervention Methods of Assessing, Planning, and Evaluating Outcomes

This section provides an evaluation of the main approaches used in the assessment, planning, and evaluation of the effectiveness of social prescribing interventions and gaps in their utilisation.

Assessing Social Prescribing Interventions

There are several ways of evaluating social prescribing interventions to determine their effects on somebody’s health. These include the general health-related quality of life (HRQoL) and the patient-reported outcome measures (PROMs) and interviews including case studies.

One of the instruments that are frequently applied is the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS) serving to identify changes in mental wellbeing levels before and after individuals’ involvement in social prescribing. In their longitudinal study, Wakefield et al. (2022) used WEMWBS and showed that the people who did social prescribing programs experienced an improvement in well-being. Nevertheless, PROMs and HRQoL scales are valuable as they offer measurable data, these are based on self-assessment and hence may include a response bias and an individual perception of the particular outcome.

Qualitative methods, like interviews or focus groups, run them through the experiences of participants. Thus, the study by Foster et al. (2021) shows the results of surveys carried out in combination with interviews to determine the effectiveness of social prescribing in reducing loneliness. Their studies revealed that while numerical results were still moderate, more descriptive information described the way an environment that focused on social prescribing enhanced the morale of the community. Nonetheless, the qualitative method has been criticised for being rather subjective and less transferable, and therefore, its results cannot be used for comparison with the results of other similar research studies.

Planning and Implementation of Social Prescribing Interventions

The planning of effective social prescribing interventions needs to be structured in an organized manner to address all the needs that are found in patients (SCIE, 2024). Therefore, to support this process, there are link workers who evaluate the patients and refer them to any service within the community.

Ahluwalia, Spicer, & Storey (2020) referred to personalisation in care planning as a key aspect of social prescribing. They identified that the patients, who were provided with properly designed social prescriptions that fit the patient’s social and health backgrounds, were more inclined to participate in such interventions and achieve the intended favourable results. They also commented that the standards in training and provision of resources for the link workers would impact the standardised service delivery systems.

One clinical model of planning is an integration of social prescribing with other primary care networks (PCNs) (SCIE, 2024). McCormack et al. (2021) discussed the way the organisation of a multi-disciplinary team, GPs, social workers, and link workers, planned social prescribing. They also observed that Co-ordinate care planning supported improved health of the patient due to increased efficiency in planning. Deficiencies including, the high number of clients to be attended to, and scarcity of community-based resources were cited as some of the issues likely to hinder effective planning (NHS England, 2023).

Evaluating the Outcomes of Social Prescribing

In order to assess the efficacy of social prescribing approaches and their impacts, useful methods of research have to integrate both the short and long-term dynamics of the interventions (dnainsight, 2016).

Social Return on Investment (SROI)

SROI is also an extensive evaluation tool that measures social and economic benefits from social prescribing processes. In strengthening the health and social care system, Hopkins et al. (2023) suggested that SROI could be employed for the evaluation of the effects of social prescribing. They argue that most of the social prescribing interventions have a high possibility of gaining high returns through such aspects as reduced GP visits and ER admissions.

Randomized Controlled Trials (RCTs)

RCTs are widely known as the most accurate means of assessing the impact of health care interventions but their use in social prescribing has been rare. According to Nowak & Mulligan (2021), although RCTs offer the best evidence for causation, the concept of social prescribing is more personalized and community-based. Therefore, it is difficult also to conduct RCT in this field as moral issues remain important here, and delivering social prescriptions for a control group is potentially depriving the people of certain health benefits associated with it.

Longitudinal and Mixed-Methods Studies

Longitudinal data analysis follows up with patients over some time to establish the sustainability of such social prescriptions. Wakefield et al. (2022) carried out a cross-sectional study to determine the changes in social connectivity in a social prescribing intervention. According to their research, their results were the beginning of such positive results though continuity of the practice greatly helped in maintaining the results.

It has been also possible to conduct a more comprehensive evaluation of the implementation of social prescribing through mixed methods, which use both quantitative and qualitative research approaches. Foster et al. (2021) showed the analysis of the application of statistical findings in combination with interviews which contributed to a better understanding of the eight participants and context.

Challenges and Limitations in Assessing, Planning, and Evaluating Social Prescribing

However, a few issues are still under debate when it comes to determining, implementing, and evaluating social prescribing effectiveness. A primary concern is that the indexes integrated in several studies are not the same, so the results are hardly compatible and offer no room for clear conclusion-weaving (Hopkins et al., 2023). Furthermore, self-reports are inconclusive because they may suffer from socially desirable response bias, whereby the participants provide more positive results than in reality.

The last alternative is managing to maintain the viability of social prescribing programs. Some of the interventions are short-term funded and the health facilities and ministries often experience shifts, which affects the services provided and the clientele. For social prescribing to work optimally in solving many of these areas’ problems, it requires long-term investment and policy support (Ahluwalia et al., 2020).

The methods used in assessing the evaluation, planning, and implementation of social prescribing interventions include different approaches that have their advantages and disadvantages. However, PROMs, and qualitative assessments, do not appear highly objective and might bring biases into the process. According to Hopkins et al. (2023), SROI provides the financial standpoint of how social prescribing works and there can be various considerations in developing the measurements. RCTs are a gold standard but the application of these may sometimes not be possible here. Longitudinal and mixed methods are considered thorough approaches but expensive at the same time.

Overall, current evidence for social prescribing interventions suggests that it does work, however, there is a need for more robust research to enhance the literature. Future research should maintain the outcomes measurement and bring equal access to the interventions and subsequently should state its future concerns about long-term explanation to facilitate the utmost benefits from social prescribing.

Conclusion

This literature review aims to review the literature on the efficacy and suitability of social prescribing interventions, the approach towards using for assessing, planning, and evaluating these interventions, and the effects the intervention has on people. The review shows that social prescribing has shown potential for the improvement of patients’ positive health, reduction of loneliness, and promotion of social inclusion. However, such programs differ in the levels of participation and identifying the available community resources or involvement of link workers in terms of extending necessary and individualized support.

The evaluation of social prescribing approaches involves mixed methods of quantitative and qualitative assessment. Although the WEMWBS and PROMs data are useful in quantitative, comparative data, qualitative research provides more detailed findings into the patient experience. It is acknowledged that social prescribing interventions should involve individuals from various fields in the planning and implementation process and this has been noted to have its weaknesses such as lack of adequate funds as well as variation in services offered.

Each of these methods; SROI, RCTs and longitudinal implies another way of capturing effectiveness, although each has its drawbacks. There is also a need to standardise different forms of assessment within social prescribing so that the sustainability of the model and its scalability can be achieved in the long run. Future research should aim at fine-tuning research approaches in a bid to enhance the accumulation of evidence to support these practices.

References

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• Foster, A., Thompson, J., Holding, E., Ariss, S., Mukuria, C., Jacques, R., Akparido, R., & Haywood, A. (2021). Impact of social prescribing to address loneliness: A mixed methods evaluation of a national social prescribing programme. Health & Social Care in the Community, 29(5), 1439–1449. https://doi.org/10.1111/hsc.13200
• Hopkins, G., Winrow, E., Davies, C., & Seddon, D. (2023). Beyond social prescribing-The use of social return on investment (SROI) analysis in integrated health and social care interventions in England and Wales: A protocol for a systematic review. PloS One, 18(2), e0277386e0277386. https://doi.org/10.1371/journal.pone.0277386
• Hopkins, G., Winrow, E., Davies, C., & Seddon, D. (2023). Beyond social prescribing—The use of social return on investment (SROI) analysis in integrated health and social care interventions in England and Wales: A protocol for a systematic review. PLOS ONE, 18(2), e0277386. https://doi.org/10.1371/journal.pone.0277386
• Husk, K., Blockley, K., Lovell, R., Bethel, A., Lang, I., Byng, R., & Garside, R. (2019). What Approaches to Social Prescribing work, for whom, and in What circumstances? a Realist Review. Health & Social Care in the Community, 28(2), 309–324. https://doi.org/10.1111/hsc.12839
• Kiely, B., Clyne, B., Boland, F., O’Donnell, P., Connolly, D., O’Shea, E., & Smith, S. M. (2021). Link Workers Providing Social Prescribing and Health and Social Care Coordination for People with Multimorbidity in Socially Deprived Areas (the LinkMM trial): Protocol for a Pragmatic Randomised Controlled Trial. BMJ Open, 11(2), e041809. https://doi.org/10.1136/bmjopen-2020-041809
• McCormack, B. et al (Eds) (2021) Fundamentals of person-centred healthcare practice: a guide for healthcare students. Chichester, West Sussex: Wiley.
• NHS England. (2023). Social Prescribing. NHS England. https://www.england.nhs.uk/personalisedcare/social-prescribing/
• Nowak, D. A., & Mulligan, K. (2021). Social prescribing: A call to action. Canadian Family Physician, 67(2), 88–91. https://doi.org/10.46747/cfp.670288
• SCIE. (2024). The Social Care Institute for Excellence (SCIE) is a not-for-profit independent social care charity. Social Care Institute for Excellence (SCIE). https://www.scie.org.uk/
• Socialprescribingacademy. (2024). Home. National Academy for Social Prescribing. https://socialprescribingacademy.org.uk/
• Wakefield, J. R. H., Kellezi, B., Stevenson, C., McNamara, N., Bowe, M., Wilson, I., Halder, M. M., & Mair, E. (2022). Social Prescribing as ‘Social Cure’: A longitudinal study of the health benefits of social connectedness within a Social Prescribing pathway. Journal of Health Psychology, 27(2), 386–396. https://doi.org/10.1177/1359105320944991
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