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

Whitelaw, S. , Thirlwall, C., Morrison, A., Osborne, J., Tattum, L. and Walker, S. (2017) Developing and implementing a social prescribing initiative in primary care: insights into the possibility of normalization and sustainability from a UK case study. Primary Health Care Research and Development, 18(2), pp. 112-121. (doi: 10.1017/S1463423616000219) (PMID:27269818)

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 wellbeing 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, 3 related datasets 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.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Whitelaw, Dr Alexander
• Authors: Whitelaw, S., Thirlwall, C., Morrison, A., Osborne, J., Tattum, L., and Walker, S.
• College/School: College of Social Sciences > School of Social & Environmental Sustainability
• Journal Name: Primary Health Care Research and Development
• Publisher: Cambridge University Press
• ISSN: 1463-4236
• ISSN (Online): 1477-1128
• Published Online: 08 June 2016
• Copyright Holders: Copyright © 2016 Cambridge University Press
• First Published: First published in Primary Health Care Research and Development 18(2): 112-121
• Publisher Policy: Reproduced in accordance with the publisher copyright policy