A scoping review to understand the effectiveness oflinking schemesfrom healthcare providers to community resources to improve the health and well-being of people with long-term conditions

Abstract

What is known about this topic• People with long-term conditions can experience physical, psychological and social problems making the overall management of their health complex.• Formal health services are unable to sufficiently address patients' psychosocial well-being.• Social prescribing allows referrals to voluntary and community sector services, broadening the scope for supporting patients with psychosocial difficulties. What this paper adds• The roles of health professionals and intervention facilitators are vital for legitimising social prescribing as a health management strategy.• Participation in wider communitybased activities has a positive impact on patients' psychosocial well-being.• A methodologically flexible approach is required for assessing the impact of social prescribing as empirical evidence is limited. AbstractThe prevalence of people living with long-term conditions is increasing, accompanied by an increased expectation that patients will become more involved in self-management. Long-term conditions are associated with increased social isolation and poor physical and mental health. But there remains a gap in health provision between providing medical treatment and effectively addressing psychosocial well-being. One potential way of addressing this gap is by utilising social interventions which link patients from health services to community-based sources of support. However, the mechanisms involved in the delivery of interventions providing that link and their effectiveness remain unclear. This review adopted the methodological framework for conducting scoping studies, searching for both academic and grey literature on social interventions which link people from healthcare settings to a range of community and voluntary sector organisations. A literature search between May and June 2013, involving five electronic databases, hand searching of two journals and the use of Google search engine, identified seven studies relevant to the review question. In terms of key characteristics and mechanisms of the interventions, mental health conditions and social isolation were the most common reasons for referral to the interventions, and referrals were usually made through general practices. Almost all the interventions were facilitator-led, whereby the facilitator worked to identify and link participants to appropriate community-based resources. In regard to health and social outcomes and their cost-effectiveness, studies reported improvement to participants' psychological and social well-being as well as their decreased use of health services, although there were limited measures of participants' physical health outcomes. Interventions for linking patients from healthcare setting to community-based resources target and address psychosocial needs of participants. The review identified involvement of health professionals in aiding the referral of patients to the intervention and the role of the intervention facilitators as key components of the interventions.

Developing and implementing a social prescribing initiative in primary care: insights into the possibility of normalisation and sustainability from a UK case study

“…Despite the identified concerns, as a result of this intrinsic capacity combined with effective external support many of May et al's (2007) 'interactional', 'relational' and 'skillbased' requirements of change towards 'normalization' were fulfilled. Mossabir et al's (2014) recognition of the specific need for GPs to have a prominent role was fulfilled in this case and this One area where there was a view that such processes could have been enhanced was in relation to impact feedback. In relation to achieving sustainable change, Moran and Avergun's (1997) point to 'tracking and monitoring' as an important motivator for sustaining and embedding change and for some informants, more frequent and detailed response would have been appreciated.…”

“…Despite Mossabir et al's (2014) concerns over the poor evidence base surrounding SP implementation, the literature did provide insights into some relevant variables -both affirmatively (Brandling & House, 2009) and in relation to various 'barriers' (Checkland et al, 2007).…”

“…Critically, realising such connections is recognised as difficult (Dickinson & Glasby, 2010) and despite gaining momentum, concerns exist over the paucity of evidence around optimal implementation processes and outcomes of SP (Brown et al, 2004); Mossabir et al (2014) noting, "very few…schemes have been empirically evaluated" (Mossabir et al, 2014: 17) and that "the mechanisms involved in the delivery of interventions…..remain unclear" (Mossabir et al, 2014: 1). This paper addresses the latter area -undertaking a critical process based evaluation of the design and implementation of a developmental SP initiative in the UK -Healthy Connections Stewartry (HCS).…”

A comprehensive service re-evaluation of the UK's first NHS generic fatigue clinic four years following its inception: a mixed methods study

“…This support means that they are less likely to feel less socially isolated. A previous scoping review of the literature has demonstrated improvements in health and well-being patients of those with long-term conditions who are linked with appropriate community resources by a facilitator [14].…”

“On their own”: social isolation, loneliness and chronic musculoskeletal pain in older adults

“…Such interventions should be tailored, not only to an individual's desires and goals towards socially engagement, but to how social isolation relates to their personal musculoskeletal pain experiences and beliefs. Whilst such strategies may be costly to both health and social care services (Husk et al, 2016;Mossabir et al, 2015), this may be offset through reduced health and service care burden in accident and emergency admissions, formal and informal carer costs and reduced primary and secondary care utilisations (Husk et al, 2016;Landeiro et al, 2016;Lim et al, 2006;Mossabir et al, 2015). Through this, biopsychosocial features of an individual's disease can be sufficiently addressed for sustainable improvements in symptom management and social engagement.…”