Navigating the national rollout: examining Primary Care Network link workers and the integration of local social prescribing models in Redbridge.

IF 1.7
Ainul Nadhirah Hanafiah, Marcello Bertotti
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引用次数: 0

Abstract

Background: Social prescribing (SP) is increasingly recognised as a key component of primary care, implemented in at least 25 countries by 2023. In England, SP has been nationally rolled out through Primary Care Networks (PCNs), though many areas, including Redbridge in East London, had pre-existing VCSE-led models. How national and local approaches integrate in practice remains underexplored.

Methods: This study used a two-step qualitative design. First, documentary analysis of service planning and evaluation documents mapped the SP referral pathway in Redbridge before and after the national rollout. Second, 16 semi-structured interviews were conducted with purposively sampled stakeholders from PCNs, RedbridgeCVS, the local authority, and the Clinical Commissioning Group, exploring service integration and delivery experiences. Data were analysed using the Framework Method, combining deductive coding against predefined themes with inductive identification of emergent categories.

Results: RedbridgeCVS was widely valued for its expertise, especially in managing complex cases, training link workers, and facilitating access to local services. However, integration across PCNs was inconsistent. Participants reported variation in GP engagement, referral processes, and support structures. PCN link workers faced capacity pressures, unclear role boundaries, and limited access to clinical supervision, affecting the sustainability and coherence of service delivery.

Conclusions: Integrating national and local SP models requires clearer leadership, standardized referral pathways, and consistent support for link workers. Without greater alignment across primary care and VCSE partners, the full potential of SP risks being undermined. Link workers must be recognized and supported as core members of the primary care team.

导航全国推出:检查初级保健网络链接工人和当地社会处方模式的整合在雷德布里奇。
背景:社会处方(SP)越来越被认为是初级保健的关键组成部分,到2023年至少在25个国家实施。在英国,SP已经通过初级保健网络(pcn)在全国范围内推广,尽管包括东伦敦雷德布里奇在内的许多地区已经存在vcse主导的模式。如何在实践中整合国家和地方的方法仍未得到充分探索。方法:采用两步定性设计。首先,对服务规划和评估文件进行文献分析,绘制了Redbridge在全国推广之前和之后的SP转诊路径。其次,对来自pcn、redbridge ecvs、地方当局和临床调试小组的利益相关者进行了16次半结构化访谈,探索服务整合和交付经验。使用框架方法对数据进行分析,结合针对预定义主题的演绎编码和紧急类别的归纳识别。结果:redbridge ecvs因其专业知识而受到广泛重视,特别是在管理复杂病例、培训链接工人和促进获得当地服务方面。然而,pcn之间的整合是不一致的。参与者报告了全科医生参与、转诊流程和支持结构的变化。PCN链接工作人员面临能力压力、角色界限不清以及获得临床监督的机会有限,影响了服务提供的可持续性和一致性。结论:整合国家和地方SP模式需要更明确的领导、标准化的转诊途径以及对链接工作者的持续支持。如果初级保健和VCSE合作伙伴之间没有更大的协调,SP的全部潜力就有可能被破坏。作为初级保健团队的核心成员,Link工作者必须得到认可和支持。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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