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Developing and implementing a social prescribing initiative in primary care: insights into the possibility of normalisation and sustainability from a UK case study

  • Sandy Whitelaw (a1), Claire Thirlwall (a2), Amy Morrison (a3), Jill Osborne (a3), Lisa Tattum (a3) and Sharon Walker (a4)...

Abstract

Aim

To conduct a process-based evaluation of the inception and early implementation of a social prescribing initiative (Healthy Connections Stewartry) in two UK General Practices.

Background

Prescribing a range of social, cultural, arts and educational activities to clients in primary care (known as ‘social prescribing’ or ‘community linking schemes’) as a means of addressing long-term physical health conditions and promoting mental health and well-being is becoming increasingly prominent and popular. However, concerns exist over a lack of evidence of effectiveness and formalised insights into how such initiatives may be optimally implemented.

Methods

Within a case study design and using 1–1 semi-structured interviews, three related data sets were developed over a 12-month period from 30 purposively sampled informants: the project steering group; the wider primary care team; and various community groups. Data analysis drew on various theoretical resources, particularly those pertaining to nurturing sufficient capacity for the organisational ‘normalisation’ of this practice and understanding the dynamic flows and linkages between potential clients, ‘prescribing’ primary care staff and the available community resources.

Findings

The inception and implementation of the initiative had been broadly successful and that more generally, there were grounds to suggest that these practices were becoming ‘normalised’ into the day-to-day cultures and routines of the primary care organisations. A series of procedural features are considered significant in achieving such ends. Some specific barriers to change are identified and ultimately in the context of potential ‘transferability’, a wider reflection is undertaken of the potential for such innovative practice to become established in less advantageous organisational circumstances. Fundamental difficulties are recognised and thus the need for formally implemented ‘change’ processes. Furthermore, for social prescribing to become a pervasive feature of health-care provision, the need for necessary capacity and resources is stressed.

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Copyright

Corresponding author

Correspondence to: Sandy Whitelaw, Lecturer Health & Social Policy, School of Interdisciplinary Studies, Dumfries Campus, University of Glasgow, Dumfries, DG1 4ZL. Email: alexander.whitelaw@glasgow.ac.uk

References

Hide All
Alcock, P. 2010: Building the big society: a new policy environment for the third sector in England. Voluntary Sector Review 1, 379389.
Boyatzis, R. 1998: Transforming qualitative information: thematic analysis and code development. Thousand Oaks, London, and New Delhi: Sage Publications..
Brandling, J. and House, W. 2009: Social prescribing in general practice: adding meaning to medicine. British Journal of General Practice 59, 454456.
British Medical Association (BMA) 2011: Social determinants of health – what doctors can do. London: BMA.
Brown, M., Friedli, L. and Watson, S. 2004: Prescriptions for pleasure. Mental Health Today, June 1, pp. 20–23.
Bungay, H. and Clift, S. 2010: Arts on prescription: a review of practice in the UK. Perspectives in Public Health 130, 277281.
Carlisle, S. 2010: Tackling health inequalities and social exclusion through partnership and community engagement? A reality check for policy and practice aspirations from a social inclusion partnership in Scotland. Critical Public Health 20, 117127.
Catford, J. 2009: Advancing the ‘science of delivery’ of health promotion: not just the ‘science of discovery’. Health Promotion International 21, 15.
Cawston, P. 2011: Social prescribing in very deprived areas. British Journal of General Practice 61, 350.
Checkland, K., Harrison, S. and Marshall, M. 2007: Is the metaphor of ‘barriers to change’ useful in understanding implementation? Evidence from general medical practice. Journal of Health Services Research and Policy 12, 95100.
Checkland, P. 2000: Soft systems methodology: a thirty year retrospective. Systems Research and Behavioral Science Systems Research 17, S11S58.
Dale, B., Doaden, R., Wilcox, M. and McQuater, R. 1997: Sustaining total quality management: what are the key issues? The TQM Magazine 9, 372380.
Dickinson, H. and Glasby, J. 2010: Why partnership working doesn’t work. Public Management Review 12, 811828.
Fenwick, T. 2010: Re-thinking the ‘thing’: sociomaterial approaches to understanding and researching learning in work. Journal of Workplace Learning 22, 104116.
Friedli, L., Jackson, C., Abernethy, H. and Stansfield, J. 2009. Social prescribing for mental health: a guide to commissioning and delivery care services. Stockport: Improvement Partnership North West Development Centre.
Goldberg, D., Mick, S., Kuzel, A., Bo Feng, L. and Love, L. 2013: Why do some primary care practices engage in practice improvement efforts whereas others do not? Health Services Research 48, 389416.
Grol, R. and Grimshaw, J. 2003: From best evidence to best practice: effective implementation of change in patients’ care. The Lancet 362, 12251230.
Halfmann, D. 2011: Recognizing medicalization and demedicalization: discourses, practices, and identities. Health 16, 186207.
Hung, D., Rundall, T., Tallia, A., Cohen, D, Halpin, H and Crabtree, B. 2007: Rethinking prevention in primary care: applying the chronic care model to address health risk behaviors. Milbank Quarterly 85, 6991.
ICEBeRG 2006: Designing theoretically-informed implementation interventions. Implementation Science 1, 4.
Lord, J. and Green, F. 1995: Exercise on prescription: does it work? Health Education Journal 54, 453464.
Marmot, M. 2008: Fair society, healthy lives: the Marmot review. London: The Marmot Review.
Marshall, M., Sheaff, R., Rogers, A., Campbell, S., Halliwell, S., Pickard, S., Sibbald, B. and Roland, M. 2002: A qualitative study of the cultural change in primary care organisations needed to implement clinical governance. British Journal of General Practice 52, 641645.
Matthews, B. and Ross, L. 2010: Research methods; a practical guide for the social sciences. London: Pearson Education.
May, C., Finch, T., Mair, F., Ballini, L., Dowrick, C., Eccles, M., Gask, L., MacFarlane, A., Murray, E., Rapley, T., Rogers, A., Treweek, S., Wallace, P., Anderson, G., Burns, J. and Heaven, B. 2007: Understanding the implementation of complex interventions in health care: the normalization process model. BMC Health Services Research 7, 148.
Moran, J. and Avergun, A. 1997: Creating lasting change. The TQM Magazine 9, 146151.
Mossabir, R., Morris, R., Kennedy, A., Blickem, C. and Rogers, A. 2014: A scoping review to understand the effectiveness of linking schemes from healthcare providers to community resources to improve the health and well-being of people with long-term conditions. Health and Social Care in the Community 23, 467484.
Olesen, F., Dickinson, J. and Hjortdahl, P. 2000: General practice – time for a new definition. British Medical Journal 320, 354357.
Plsek, P.E. and Greenhalgh, T. 2001: Complexity science: the challenge of complexity in health care. British Medical Journal 323, 625628.
Potter, C. and Brough, R. 2004: Systemic capacity building: a hierarchy of needs. Health Policy Planning 19, 336345.
Rolfe, G. 2006: Validity, trustworthiness and rigour: quality and the idea of qualitative research. Journal of Advanced Nursing 53, 304310.
Ross, J. and Kettles, A. 2012: Mental health nurse independent prescribing: what are nurse prescribers’ views of the barriers to implementation? Journal of Psychiatric and Mental Health Nursing 19, 916932.
Scottish Government 2011: Health of Scotland’s population – mental health. Edinburgh: Scottish Government.
Scottish Government 2012: Mental health strategy for Scotland 2012–2015. Edinburgh: Scottish Government.
Scottish Government 2013: Route map to the 2020 vision for health and social care. Edinburgh: Scottish Government.
Scottish Government/COSLA/NHS Scotland 2011: Reshaping care for older people: a programme for change. Edinburgh: Scottish Government.
Sibthorpe, B., Glasgow, N. and Wells, R. 2005: Emergent themes in sustainability of primary health care innovation. The Medical Journal of Australia 183, 7780.
South, J., Higgins, T., Woodall, J. and White, S. 2008: Can social prescribing provide the missing link? Primary Health Care Research and Development 9, 310318.
Stake, R. 1995: The art of case study. London: Research Sage.
Starfield, B, Shi, L. and Macinko, J. 2005: Contribution of primary care to health systems and health. Milbank Quarterly 83, 457502.
Taylor, B., Mathers, J., Atfield, T. and Parry, J. 2011: What are the challenges to the big society in maintaining lay involvement in health improvement, and how can they be met? Journal of Public Health 33, 510.
White, J., Kinsella, K. and South, J. 2010: An evaluation of social prescribing health trainers in South and West Bradford. Leeds: Leeds Metropolitan University.
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Primary Health Care Research & Development
  • ISSN: 1463-4236
  • EISSN: 1477-1128
  • URL: /core/journals/primary-health-care-research-and-development
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