Viewpoint: Social prescribing link workers are all about general practice medicine

Christiana Melam, chief executive of the National Association of Link Workers, explains how social prescribing link workers can help GPs deliver patient-focused, holistic care.

National Association of Link Workers chief executive Christiana Melam
National Association of Link Workers chief executive Christiana Melam

Social prescribing Link Workers enable general practice to live and breadth the ethos of general practice medicine, which is about focusing on the whole person combining physical, psychological and social aspects of care.

Today (8 October) is Link Workers Day 2021 and it is important to reflect on the valuable role of social prescribing link workers play in general practice in reducing health inequalities.

Social prescribing link workers are about general practice medicine - what do I mean by this?

General practice medicine with social prescribing support

General practice medicine is about focusing on the whole person combining physical, psychological, and social aspects of care.

Many GPs face an impossible task - brief appointment times within which to assess and address a patient's health. Understandably, the immediate presenting medical complaint takes priority and clinicians are rarely afforded time to adequately address any non-medical causes of illness.

The social prescribing link worker can support GPs by uncovering and addressing the non-medical concerns of the patient, as our new report demonstrates. The link worker has access to the 'whole' person over a longer period. As a non-medical professional, the nature of the interaction between the patient and the social prescribing link worker focuses not only on the physical symptoms of their illness but also on the wider social determinants of health that might contribute to those symptoms.

By working closely with social prescribing link workers, GPs can deliver holistic care to people, prevent unnecessary medical appointments and reduce overprescribing, therefore saving NHS time and resources.

Health inequalities

Social prescribing link workers also play a critical role in helping to reduce inequalities. By uncovering the individual factors responsible for health and finding the unique motivations and incentives for the individual, the link worker helps the individual to co-produce a personalised plan.

This strengths-based approach facilitates the patient to activate their assets and take control of their own health and wellbeing. The social prescribing link worker can support the individual in behaviour change over time. The result avoids unnecessary medical and pharmaceutical intervention and enables patients to take charge of their narrative.

Case study

Mrs C is a 55-year-old woman with a BMI of 30. She presents to her GP for a check-up after previously starting treatment for essential hypertension. Her blood pressure is now 124/70, and she is otherwise well.

Her GP discusses the importance of adhering to medication and briefly discusses lifestyle changes such as weight loss, exercise, and dietary changes. The GP suggests joining a gym or an exercise class, which she didn't.

In this scenario, the social prescribing link worker works alongside the primary care team to explore the patient's background and context, resulting in personal, appealing and sustainable interventions.

Six months later, Mrs C returns for a routine follow-up with the GP. Her weight is unchanged, and her blood pressure is borderline high.

The GP refers her to the social prescribing link worker, who visits Mrs C and spends some time talking to her. That consultation reveals that Mrs C felt unmotivated to attend the gym, as she felt this was a space for younger, fitter people and felt embarrassed to exercise in a public space. She tried jogging, but this hurt her knees.

The link worker recommends a walking program to Mrs C, who didn't know this was an option. Mrs C feels comfortable doing this in public. The social prescribing link worker attends the first group with her, as she was feeling nervous.

After being supported by the link worker, Mrs C feels empowered and newly motivated and she feels comfortable attending the group on her own. She goes on to lose 10kg over the following months, and her blood pressure remains stable on one medication.

This case shows how the social prescribing link worker identified barriers preventing a patient from following her GP's suggestions and collaboratively working out alternative solutions. An achievable personalised care plan was co-produced.

Embedding social prescribing across the NHS

The #LinkWorkerDay2021 awards Winner for social prescribing programme of the year, Enable Leisure and Culture, shows the difference social prescribing can make.

The group approach highlights a 360-degree view of care and a fully integrated social prescribing model across adult social care, primary care and the wider NHS. It has a strong emphasis on reducing social inequalities and reaching out to under-represented groups.

The team employs generalist and specialist link workers, superb partnership working and collaboration and has a real commitment to expanding capacity in voluntary and community groups. It has an outstanding commitment to staff welfare, development and progression with strong evidence of its impact.

The group also highlights of the reasons we need to expand the rollout of social prescribing to increase capacity so that we don't just provide access to those registered at the practice. What about those not registered and present at A&E?

We need to ensure all areas of the health service are able access to social prescribing link workers to reduce access inequality.

  • Christiana Melam is the Chief Executive of the National Association of Link Workers; you can follow her on twitter @Christy_Melam

Download the National Association of Link Workers report The Role of Social Prescribing Link Workers in Reducing Health Inequalities here

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