Social Prescribing and Integrated Care: An Evaluability Assessment

Background:

The landscape of healthcare is in a constant state of flux universally. In the United Kingdom (UK) for instance, there is a desperate need to fund the National Health Service (NHS) to better reflect the populace at a local level. In response, the NHS Five Year Forward View was published and it was noted amongst other things that a “one size fits all” model of care was simply, no longer practical. As part of delivering this remit, new models of care have been designed to not only deliver more integrated care, but to create partnerships at the community level . One such model is the Encompass multispecialty community provider (MCP), which is one of 14 ‘vanguards’ established across the UK in response to improving the integration of health and social care whilst also looking towards non-clinical resolutions when appropriate. This necessity to pursue a more inclusive and sustainable approach to health has allowed concepts such as social prescribing to rise to prominence.

The social prescribing service associated with this scheme; Red Zebra Community Solutions has been tailored to the needs of this MCP by referring and/or signposting patients to non-medical services (i.e. befriending services to combat social isolation) within the community. Based on the needs of the locality, this social prescribing service aims to:

•Provide a referral database that will allow residents within the Encompass MCP catchment area to access local activities and services

•Provide a social, rather than medical solution when suitable

•Reduce the number of unnecessary appointments and hospital admission(s)

Method:

An evaluability assessment was undertaken of this local social prescribing service to determine if at present there was enough evidence to carry out a full evaluation of Red Zebra in relation to the MCP.

It was agreed that the key criteria to consider were:

•The quality of the project purpose

•The quality of expected outputs

•The availability of baseline and monitoring data

•The feasibility of attribution

Data Collection:

To address the key criteria the research team collated and analysed information related to the Encompass MCP developed logic model for social prescribing and Red Zebra’s own narrative. This included Red Zebra’s history, aims, objectives, staff job descriptions, copies of client feedback forms and the social prescribing platform they utilise to undertake their work. In-person interviews were also undertaken with social prescribing managers and case officers as well as commissioners engaged with the Encompass MCP process.

Conclusion:

There is evidence of engagement with voluntary and community support services particularly amongst the older patient population for social isolation. Additionally, there is evidence that GPs are referring patients for social prescribing support although, it is not possible to determine whether Red Zebra itself has increased awareness of community support services among GPs or patients.

Whilst promising, in future, the outcome data collected by Red Zebra will need to expand to include a formal assessment of client perceived benefits and anticipated outcomes of the service itself (i.e. measures of psychosocial wellbeing) to permit an evaluation.