ORCID

Abstract

Background: Following the 2019 NHS Long-Term Plan, link workers (LWs) have been employedacross primary care in England to deliver social prescribing (SP).Aim: To understand and explain how the LW role is being implemented in primary care in England.Design and setting: Realist evaluation undertaken in England.Method: Focused ethnographies around seven LWs from different parts of England. As part of this,we interviewed 61 patients and 93 professionals from healthcare and the voluntary, community andsocial enterprise (VCSE) sector. We reinterviewed 41 patients, seven LWs and a LW manager 9-12months after their first interview.Results: We developed four concepts around how LWs are integrated (or not) within primary care:Centralising or diffusing power; Forging an identity in general practice; Demonstrating effect;Building a facilitative infrastructure. These concepts informed the development of a programmetheory around a continuum of integration of LWs into primary care – from being ‘bolted on’ toexisting provision, without much consideration, to ‘fitting in’, shaping what is delivered to beaccommodating, through to ‘belonging’, whereby they are accepted as a legitimate source ofsupport, making a valued contribution to patients’ broader well-being.Conclusion: SP was introduced into primary care to promote greater attention to the full range offactors affecting patients’ health and well-being, beyond biomedicine. For that to happen, ouranalysis highlights the need for a whole system approach to defining, delivering and maintaining thisnew part of practice.

DOI

10.3399/BJGP.2024.0279

Publication Date

2024-09-24

Publication Title

British Journal of General Practice

ISSN

0960-1643

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