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Social prescribing is a non-medical option intervention which links patients in primary care with sources of support within the community. It is defined by the Social Prescribing Network as “‘a means of enabling GPs and other frontline healthcare professionals to refer patients to a link worker - to provide them with a face to face conversation during which they can learn about the possibilities and design their own personalised solutions, i.e. ‘co-produce’ their ‘social prescription’- so that people with social, emotional or practical needs are empowered to find solutions which will improve their health and wellbeing, often using services provided by the voluntary and community sector”’. The NHS Long Term Plan includes commitments to extend personalised care throughout England. By 2024, at least 2.5m people are expected to benefit from the implementation of the comprehensive model of personalised care. This includes at least 900,000 people who will be referred to social prescribing and 200,000 people with a personal health budget.
A challenge is evaluating the delivery and impact of the programme. Within London, the Whole Systems Integrated Care (WSIC) dataset provides a major opportunity to evaluate the impact and outcomes of personalised care across NW London, and to inform national work. WSIC combines data from four acute, two mental health and two community Trusts across eight CCGs, social care data from eight boroughs and 380 GP practices to generate an integrated care record.
Across the UK, GPs have been increasingly using a scale called the Patient Activation Measure (PAM) to determine who could benefit from social prescribing or other forms of personalised care. PAM is an instrument that assesses patients’ knowledge, skills and confidence for self-managing their health and long-term conditions. Higher PAM scores are associated with better health across a range of outcome measures as well as (in some settings) lower health care costs. However, the relationship between PAM and health care utilisation in the UK has not been confirmed. Further, it is unclear who the people are who receive a PAM and then get referred to social prescribing, and whether there are inequalities in who is taking up or declining social prescribing referrals.
Therefore, in this project, we:
- Explored the association between PAM and health service utilisation both cross-sectionally and over time (including primary care, outpatient care, admitted patient care, and A&E care).
- Identified who was being offered social prescribing in North West London, and whether there were any systematic differences between patients who took up or declined the service.
The study ran across 2019-2020 and was funded by NHS England.
Principal Investigator: Dr Feifei Bu
Contact: Dr Feifei Bu
Collaborators: Dr Daisy Fancourt (UCL), NHS England