Weathering the storm: A qualitative study of social prescribing in urban and rural Scotland during the COVID-19 pandemic

Alison Fixsen, Simon Barrett and Michal Shimonovich 2021. Weathering the storm: A qualitative study of social prescribing in urban and rural Scotland during the COVID-19 pandemic. SAGE Open Medicine . https://doi.org/10.1177/20503121211029187

TitleWeathering the storm: A qualitative study of social prescribing in urban and rural Scotland during the COVID-19 pandemic
TypeJournal article
AuthorsFixsen, Alison
Barrett, Simon
Simonovich, Michal
Abstract

Objectives
The non-clinical approach known as social prescribing aims to tackle multi-morbidity, reduce GP workload and promote wellbeing by directing patients to community services. Usual in-person modes of delivery of social prescribing have been virtually impossible under social distancing rules. Our study qualitatively examined and compared the responses of three social prescribing schemes in Scotland to the Covid-19 pandemic.

Methods
We interviewed a theoretical sample of 23 stakeholders of urban and rural social prescribing schemes at the start of Covid-19 pandemic. Follow up interviews with a representative sample were conducted around ten months later. Interviewees included social prescribing coordinators (SPCs) GPs, managers, researchers and representatives of third sector organizations. Interview transcripts were analysed in stages and an inductive approach to coding was supported by NVivo.

Results
Findings revealed a complex social prescribing landscape in Scotland with schemes funded, structured and delivering services, in diverse ways. Across all schemes, working effectively during the pandemic and shifting to online delivery had been challenging and demanding, however their priorities in response to the pandemic had differed. With GP time and services stretched to limits, GP practice-attached ‘Link Workers’ had taken on counselling and advocacy roles, sometimes for serious mental health cases. Community-based SPCs had mostly assumed a health education role, and those on the Western Isles of Scotland a digital support role. In both rural or urban areas, combatting loneliness and isolation- especially given social distancing- remained a pivotal aspect of the SPC role.

Conclusions
Our study highlights significant challenges and shifts in focus in social prescribing in response to the pandemic. Use of multiple digital technologies has assumed a central role in social prescribing and this situation seems likely to remain. With statutory and non-statutory services stretched to their limits, there is a danger of SPCs assuming new tasks without adequate training or support.

KeywordsSocial prescribing
qualitative studies
COVID-19
community services
JournalSAGE Open Medicine
ISSN2050-3121
Year2021
PublisherSage
Accepted author manuscript
License
CC BY 4.0
File Access Level
Open (open metadata and files)
Publisher's version
License
CC BY 4.0
File Access Level
Open (open metadata and files)
Digital Object Identifier (DOI)https://doi.org/10.1177/20503121211029187
Web address (URL)https://journals.sagepub.com/doi/full/10.1177/20503121211029187
Publication dates
Published30 Jun 2021
Supplemental file
License
CC BY 4.0
File Access Level
Open (open metadata and files)

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