Organising Theme


Example quote

Theoretical underpinning: solution focused, strengths-based

1. Solution building, strengths, positivity and future-orientated

P3: We use an assets and strength based approach. And when you support them to recognise their strengths and their assets, that can be really empowering for them

P3: We ask them about their, their sense of positivity, their sense of hope for the future, where they feel at moment there

2. Asking questions rather than telling patients what to do

P6: So, its not, its not telling people its questioning them. So, they can give their own answers, I would never tell them to, you know, attend this group, it will be great for you. Because it might not be

3. Goal and action orientated

P9: So, we do a lot of reflection back, summarising what theyve said, clarifying what theyve said, helping them to set some goals that are realistic. Often people have got high expectations of themselves. So, the goal setting, SMART Goal Setting element of it

4. Motivational interviewing techniques

P7: I think I do use them [MI techniques], but without actually knowing, or didnt know what they, that I was actually doing it. Just person-led and, you know, showing empathy to, to the person and listening and taking the time

5. Underpinning philosophy ‘What matters to the individual’

P1: It feels like its quite a profound thing about talking to someone, hearing their story, hear what matters to them, the meaning that they give to their lives, and what they would like to be different

Patients drive and lead the process

1. Agency, autonomy, empowerment, and self-management

P12: Its about personal empowerment, people taking their health and really self-care, self-care tips, you know, do something for yourself, taking the agency for yourself, go for a walk, theres a lot of people that are relying on everybody else to sort things for them. But really, were accountable for ourselves, were responsible for ourselves

2. Active engagement, not passive recipients

P7: They have to be motivated to make change… otherwise, its never its never going to happen. I think they need to be prepared to try new things that might take them out of their comfort zone. And I think they have to put in some time and effort

3. Flexible structure informed by patients’ needs

P17: So, most of the time everything is over the phone, although I did have patients who felt a face to face is more appropriate for them because of anxiety, you know, whatever reasons. So, I do see them. If theyre scared coming out their homes, well go to their homes.

4. Patients tell their stories, have the time and space to talk

P3: Listening, giving someone time to talk, and tell their story

P16: I think its listening. Its listening to their story. That makes a massive difference to be able to hear their story, but also hear it well enough that they know that youre properly listening

Social prescription link workers guide, facilitate and support

1. SPLW a support mechanism, for opportunity and resource access

P7: Its making people aware of activities and opportunities that are available in the community that they might not have been aware of and walking alongside those people to introduce them and help them to access those

2. Door is always open to re-engage with SPLW

P4: So, there is kind of the doors are always open, kind of feel. They are always welcomed back in

P12: And I’m trying to discharge people, but always say you’re very welcome to really re-refer in the future if you need us

3. Get to know the patient, create a therapeutic alliance

P7: So, just have an open conversation. And because you’ve invested the time, building that rapport and that confidence with that person, then it does mean that you can have more real-world conversations with them. You dont have to tread on eggshells, you can be quite direct about certain things, because you have got that bond. And they do trust you

4. Linking the person to the best suited personalised resources

P4: The role in itself is linking patients or people into support that can offer either for emotional or practical support, so that, that would mean identifying needs and where that support may come from

Identification and development of collaborative networks

1. Community engagement: social connectedness and inclusion

P10: Being stronger and more confident, more resilient. Embracing more social opportunities in their community, hopefully taking part in different activities, different exercise opportunities in their local community, and building links in friendships

2. Networking and forging relationships with community providers

P5: A really big part of my role has been sort of building those relationships with community groups and things that we can, sort of the people might access. Id say quite a lot of my work is around that relationship building, building those relationships for referrals

3. A network of SPLWs for emotional and practical support

P2: We’re a very big county, we have four or five different providers. There are opportunities to get together. So, weve got what we call communities of practice, that we meet once a month, we also have county wide groups that meet

Outcomes from the social prescribing approach

1. Individual achievements, positive change

P1: Theyre in better social networks they dont feel so isolated, but also physical health benefits as well that come from that feeling of well-being

2. Gratitude, patients reflecting significant differences made to their lives

P18: Somebody said how much difference the work that has been done around social prescribing with them. Yeah, that just made a huge amount of difference to their lives. And somebody once told me that it saved their life

3. Provision of green spaces, community interventions and resources

P12: Weve got these workshops that are more targeted, health and wellbeing the next one is a series of bereavement, and then I think weve got anxiety and mindfulness. I think things will grow organically

Threats to success

1. Demanding workload: overwhelming referrals, caseload and waiting lists

P7: I think on our current project, the expectation is that would work with 60 people. Ive got over 30 at the moment, and Im kind of maxed out on, on that. But thats a constant sort of pressure thats in the back of your mind

2. Inappropriate referrals, poor understanding of scope of role

P2: I think just, overwhelming number of referrals. Just too many, and a misunderstanding of what social prescribing is. So, we get, get too many referrals because of the misunderstanding of what it is

3. Risk of patient dependency

P14: Some Social Prescribers are offering that some people ring every week, which is not, they become reliant on you. but we try not do it weekly, because first of all, they just, they become very reliant on you

4. Issues with availability of and access to support services and resources

P15: I think for some people, the one thing that does seem to be quite lacking, when people do have particular mental health issues. I dealt with one issue that was far and above my, remit

5. Systems, paperwork and admin

P10: Admin. In fact, I had my annual review, two or three weeks ago now and speaking to my manager about this, and there are days when Im spending more time doing admin than I am seeing patients, to me that priority, that priority is wrong