Greater clarity and specialist training is needed to get the best out of social prescribing, new research* shows.
Social prescribing – which includes schemes such as volunteering, arts activities, cookery, gardening and a range of sports — has recently gained momentum as a means of helping to manage rising workloads in general practice.
To bolster delivery of social prescribing, the NHS has announced it will train 1000 “link workers” by the end of 2020/2021. “Care navigator” is another term that has been used to describe this role, which is already being implemented in some parts of England. People providing care navigation connect patients to local groups and support services to address their non-medical needs.
In some primary care settings, care navigation may be an additional element of a receptionist’s existing job, whereby they signpost patients to alternatives to medical care. In other cases, dedicated employees spend time with patients, co-producing individual action plans with them and identifying suitable schemes.
Despite being a priority NHS policy, researchers from the University of Oxford, whose findings appear this week in the British Journal of General Practice, note that an understanding of how care navigation works, identifying which patients are most likely to benefit, and under which circumstances is lacking.
Furthermore, there has been no systematic assessment to compare and contrast how the role is being implemented.
To address these knowledge gaps, Stephanie Tierney and colleagues surveyed all the clinical commissioning groups in England to find out how the new scheme is working.
They note that over 90% of those who replied had some form of care navigation running in their area. However, the ways in which this was being provided were variable, with much of the signposting being done by practice reception staff, often without specific training. Clear guidance and training is needed, they say, to maximise uptake and impact.
In particular, appropriate training should be offered to non-clinical members of staff if they are offering care navigation, to ensure they are working with patients who might benefit and do not overlook cases that actually require medical assistance.
The authors stress that communication about the role of care navigators should be clear, so patients do not feel they are simply being blocked from seeing their GP.
Commenting, Stephanie Tierney said: “Our research highlights the diverse ways in which care navigator type roles (including link workers) have been implemented across England. This may be confusing for patients and healthcare professionals who refer to such services in terms of what this position aims to address, for whom and how. Without greater clarity, the acceptance and uptake of such services by key stakeholders could be hindered.”
*Tierney S, Wong G, Mahtani KR. Current understanding and implementation of ‘care navigation’ across England: a cross-sectional study of NHS clinical commissioning groups. British Journal of General Practice, 9 September 2019; DOI: 10.3399/bjgp19X705569