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Results for 'primary care'

Results 1 - 10 of 13

Social prescribing could empower patients to address non-medical problems in their lives

NATIONAL INSTITUTE FOR HEALTH RESEARCH
2020

This NIHR Alert reports on a review carried out by researchers on the NIHR Evidence Synthesis Working Group to understand how GP social prescribing schemes work and when they are most effective. Researchers reviewed 118 documents evaluating social prescribing schemes and the link worker role in the UK. They found social prescribing schemes increase patients’ confidence, motivation and the skills to manage their own wellbeing - which may reduce their reliance on GPs. These positive outcomes were only achieved when patients, GPs and healthcare managers were clear about the value of social prescribing schemes and when link workers had sufficient time and resources to form a connection with patients, with the voluntary/community sector and with healthcare staff.

Reducing emergency hospital admissions: a population health complex intervention of an enhanced model of primary care and compassionate communities

ABEL Julian, et al
2018

Background: Reducing emergency admissions to hospital has been a cornerstone of healthcare policy. Little evidence exists to show that systematic interventions across a population have achieved this aim. The authors report the impact of a complex intervention over a 44-month period in Frome, Somerset, on unplanned admissions to hospital. Aim: To evaluate a population health complex intervention of an enhanced model of primary care and compassionate communities on population health improvement and reduction of emergency admissions to hospital. Design and setting: A cohort retrospective study of a complex intervention on all emergency admissions in Frome Medical Practice, Somerset, compared with the remainder of Somerset, from April 2013 to December 2017. Method: Patients were identified using broad criteria, including anyone giving cause for concern. Patient-centred goal setting and care planning combined with a compassionate community social approach was implemented broadly across the population of Frome. Results: There was a progressive reduction, by 7.9 cases per quarter (95% confidence interval [CI] = 2.8 to 13.1, P = 0.006), in unplanned hospital admissions across the whole population of Frome during the study period from April 2013 to December 2017, a decrease of 14.0%. At the same time, there was a 28.5% increase in admissions per quarter within Somerset, with a rise in the number of unplanned admissions of 236 per quarter (95% CI = 152 to 320, P<0.001). Conclusion The complex intervention in Frome was associated with highly significant reductions in unplanned admissions to hospital, with a decrease in healthcare costs across the whole population of Frome.

What approaches to social prescribing work, for whom, and in what circumstances? A realist review

HUSK Kerryn, et al
2020

The use of non‐medical referral, community referral or social prescribing interventions has been proposed as a cost‐effective alternative to help those with long‐term conditions manage their illness and improve health and well‐being. However, the evidence base for social prescribing currently lags considerably behind practice. In this paper, we explore what is known about whether different methods of social prescribing referral and supported uptake do (or do not) work. Supported by an Expert Advisory Group, we conducted a realist review in two phases. The first identified evidence specifically relating to social prescribing in order to develop programme theories in the form of ‘if‐then’ statements, articulating how social prescribing models are expected to work. In the second phase, we aimed to clarify these processes and include broader evidence to better explain the proposed mechanisms. The first phase resulted in 109 studies contributing to the synthesis, and the second phase 34. We generated 40 statements relating to organising principles of how the referral takes place (Enrolment), is accepted (Engagement), and completing an activity (Adherence). Six of these statements were prioritised using web‐based nominal group technique by our Expert Group. Studies indicate that patients are more likely to enrol if they believe the social prescription will be of benefit, the referral is presented in an acceptable way that matches their needs and expectations, and concerns elicited and addressed appropriately by the referrer. Patients are more likely to engage if the activity is both accessible and transit to the first session supported. Adherence to activity programmes can be impacted through having an activity leader who is skilled and knowledgeable or through changes in the patient's conditions or symptoms. However, the evidence base is not sufficiently developed methodologically for us to make any general inferences about effectiveness of particular models or approaches.

An evaluation of Wolverhampton's social prescribing service: a new route to wellbeing

MASSIE Rachel, AHMAD Nahid
2019

An independent evaluation of Wolverhampton social prescribing pilot service, which was launched in 2017 by the Clinical Commissioning Group in collaboration with Wolverhampton Voluntary Sector Council. The evaluation found that the service, which provides a link between primary care services and voluntary and community organisations for those with non-clinical issues, is highly regarded. A total of 676 referrals were received between May 2017 and December 2018. The most common reasons for referral were loneliness and low-level mental health conditions. Link workers made onward referrals to over 150 groups and services. Participants reported a positive impact on mental health, wellbeing, confidence, self-esteem, and even physical health for those who had been referred. The report estimates that Return on Investment means that for every £1 spent on the social prescribing intervention, there will be a saving of £0.15 for primary care services. The researchers recommended further awareness-raising activities, quarterly progress reports and better communication to service users around the nature of the service and wider access, as well as improved data capture.

Understanding the effectiveness and mechanisms of a social prescribing service: a mixed method analysis

WOODALL James, et al
2018

Background: Evidence of the effectiveness of social prescribing is inconclusive causing commissioning challenges. This research focusses on a social prescribing scheme in Northern England which deploys ‘Wellbeing Coordinators’ who offer support to individuals, providing advice on local groups and services in their community. The research sought to understand the outcomes of the service and, in addition, the processes which supported delivery. Methods: Quantitative data was gathered from service users at the point they entered the service and also at the point they exited. Qualitative interviews were also undertaken with service users to gather further understanding of the service and any positive or negative outcomes achieved. In addition, a focus group discussion was also conducted with members of social prescribing staff to ascertain their perspectives of the service both from an operational and strategic perspective. Results: In total, 342 participants provided complete wellbeing data at baseline and post stage and 26 semi-structured qualitative interviews were carried out. Improvements in participants’ well-being, and perceived levels of health and social connectedness as well as reductions in anxiety was demonstrated. In many cases, the social prescribing service had enabled individuals to have a more positive and optimistic view of their life often through offering opportunities to engage in a range of hobbies and activities in the local community. The data on reductions in future access to primary care was inconclusive. Some evidence was found to show that men may have greater benefit from social prescribing than women. Some of the processes which increased the likelihood of success on the social prescribing scheme included the sustained and flexible relationship between the service user and the Wellbeing Coordinator and a strong and vibrant voluntary and community sector. Conclusions: Social prescribing has the potential to address the health and social needs of individuals and communities. This research has shown a range of positive outcomes as a result of service users engaging with the service. Social prescribing should be conceptualised as one way to support primary care and tackle unmet needs.

What do older people experiencing loneliness think about primary care or community based interventions to reduce loneliness? A qualitative study in England

KHARICHA Kalpa, et al
2017

Twenty-eight community dwelling people, aged 65 and over who reported being ‘lonely much of the time’ or identified as lonely from the de Jong Gierveld six-item loneliness scale in a larger study, participated in in-depth interviews, between June 2013 and May 2014. Views and experiences on seeking support from primary care and community based one-to-one and group based activities, including social and shared interest groups, were explored. Interviews were recorded and transcribed. Thematic analysis was conducted by a multidisciplinary team, including older people. Using two different measures of loneliness enabled a spectrum of loneliness experience to be explored. Two-thirds of the participants were the ‘younger old’ and all were able to leave their homes independently. Older people with characteristics of loneliness were generally knowledgeable about local social and community resources but, for the majority, community and primary care based services for their loneliness were not considered desirable or helpful at this point in their lives. However, group based activities with a shared interest were thought preferable to one-to-one support (befriending) or groups with a social focus. Descriptions of support as being for loneliness and specific to older people discouraged engagement. Older people experiencing or at risk of loneliness did not consider that primary care has a role in alleviating loneliness because it is not an illness. They thought primary care practitioners lack understanding of non-physical problems and that a good relationship was necessary to discuss sensitive issues like loneliness. For many, loneliness was a complex and private matter that they wished to manage without external support.

A review of the evidence assessing impact of social prescribing on healthcare demand and cost implications

POLLEY M., et al
2017

This paper critically appraises the current evidence as to whether social prescribing reduces the demand for health services and is cost effective. It draws on the results of a systematic review of online databases which identified 94 reports, 14 of which met the selection criteria. They included studies on the effect of social prescribing on demand for general practice, the effect on attendance at accident and emergency (A&E) and value for money and social return on investment assessments. The evidence broadly supports the potential for social prescribing to reduce demand on primary and secondary care, however, the quality of the evidence is weak. It also identifies encouraging evidence that social prescribing delivers cost savings to the health service, but this is not proven or fully quantified. In conclusion, the paper looks at the possible reasons for the growth in scale and scope of social prescribing across the UK and makes recommendations for more evaluations of on-going projects to assess the effectiveness of social prescribing.

The role of advice services in health outcomes: evidence review and mapping study

PARKINSON Andy, BUTTRICK Jamie
2015

Evidence review, undertaken through a joint project between the Low Commission and the Advice Services Alliance, to examine the impact of social welfare advice services on health outcomes. The review outlines key findings from 140 research studies and also provides an overview of 58 integrated health and welfare advice services. Advice services covered in the review included those providing advice on debts, welfare benefits, housing, employment and discrimination advice. The results of the evidence review are discussed across the following areas: health inequalities; debt and mental health; primary care; secondary and tertiary care, including mental health services. The analysis finds that welfare advice provided in health context results in better individual health and well-being and lower demand for health services. Positive effects on health and welbeing include: lower stress and anxiety, better sleeping patterns, more effective use of medication, smoking cessation, and improved diet and physical activity. It shows how the right welfare advice in the right place produces real benefits for patient health especially where advice services work directly with the NHS and care providers, and presents evidence to show that early and effective advice provision reduces demand on the NHS. It provides recommendations for NHS, Local Authority Commissioners, Health and Wellbeing Boards, and the advice sector for the use welfare advice services to improve health outcomes, address health inequalities and reduce demand on the NHS.

Developing asset based approaches to primary care: best practice guide

INNOVATION UNIT, GREATER MANCHESTER PUBLIC HEALTH NETWORK
2016

This is a practical guide for getting started and growing asset based primary care at scale. It highlights examples of asset based approaches from both within Greater Manchester and beyond. Assets can be broadly grouped into: personal assets e.g. the knowledge, skills, talents and aspirations of individuals; social assets e.g. relationships and connections that people have with their friends, family and peers; community assets e.g. voluntary sector organisations (VSO) associations, clubs and community groups; and neighbourhood assets e.g. physical places and buildings that contribute to health and wellbeing such as parks, libraries and leisure centres. Drawing on research with commissioners, GPs, the community and voluntary sector, public health professionals, patients and the general population, the guide sets out what it takes to make asset based primary care work in practice, and what it would take to adopt it, not just in isolated pockets but across a whole neighbourhood, system or region. It details the background to asset based care, presents ten case studies and makes recommendations for how to develop an asset based primary care in a locality. Key steps to developing and implementing an assets-based approach include: setting up a team to lead the work; understanding which patients to focus on; understanding and mapping the user journey; understanding which approach will work best in a community; creating a development plan for the neighbourhood team; implementing and evaluating the plan; and planning for sustainability.

Framework for patient and public participation in primary care commissioning

NHS ENGLAND
2016

A guide for primary care commissioners in NHS England and Clinical Commissioning Groups (CCGs) on how to involve patients, service users, carers and the public in the commissioning of primary care services. This includes involving throughout the commissioning process in the planning, policy making, buying and monitoring primary care services such as general practice, community pharmacy, dental, and eye health services. The Framework looks at how NHS England involves people in commissioning at national and local levels; co-commissoning with CCGs; and individual responsibilities as a policy or commissioning manager in primary care. It also includes short case study examples, provides details of additional sources of information, and key partner organisations and networks with an interest in public participation. It has been co-designed with members of the Working Group for Patient and Public Participation in Primary Care Commissioning and also incorporates feedback received from key stakeholders. The document will also be of interest to patients and the public, the voluntary sector, and providers of health and social care services. It is designed to be read with the NHS England Patient and Public Participation Policy and the Statement of Arrangements and Guidance on Patient and Public Participation in Commissioning.

Results 1 - 10 of 13

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