Delivering a Primary Care-based social prescribing initiative: a qualitative study

Background: ‘Social prescribing’ is a collaborative approach to improve inter-sectoral working between primary healthcare and community organisations. The Links Worker Programme (LWP) is a social prescribing initiative in areas of high deprivation in Glasgow, Scotland aiming to mitigate the negative impacts of the social determinants of health. Aim: To uncover issues relevant to implementing a social prescribing programme to improve inter-sectoral working to achieve public health goals. Design and Setting: Qualitative interview study with 30 community organisation representatives in LWP areas, and six Community Links Practitioners (CLPs) in LWP practices. Methods: Audio recordings of interviews were transcribed verbatim and analysed thematically. Results: Participants identified benefits of collaborative working, particularly the CLPs’ ability to act as patients’ case manager, and their position within GP practices which operated as a bridge between organisations. However, benefits were seen to flow from new relationships between individuals within community organisations and CLPs, rather than more generally with the practice as a whole. Challenges to the LWP were related to capacity and funding for community organisations in the context of austerity. Capacity of CLPs was also an issue given their role involved time-consuming, intensive case management. Conclusions: While the LWP appears to be a fruitful approach to collaborative case management, integration initiatives such as social prescribing cannot be seen as ‘magic bullets’. In the context of economic austerity such approaches may not achieve their potential unless funding is available for community organisations to continue to provide services and make and maintain their links with primary care.