How to… hire social prescribing link workers

As the social prescribing workforce is expanding in primary care, Dr Pipin Singh explains why the role is valuable for PCNs

We have seen a big increase in austerity, childhood poverty and social deprivation over the past 10 years. It is widely recognised that a significant percentage of GP consultations are due to social problems such as housing, financial and employment issues.

Social prescribing allows patients to be directed down a path that takes account of all these social factors and formulates a holistic plan that can have a positive impact on their physical and mental health,
as well as their role in society.

What are the requirements of the role?
The social prescriber works in a GP practice and, with the help of clinicians and the administrative team, identifies patients who would benefit from a holistic overview of their care.

They should work within the multidisciplinary team (MDT) providing psychosocial interventions such as setting goals, signposting to other organisations, agenda setting, setting boundaries and promotion of self-management.

The social prescriber should be trained in promoting motivational change and recognise the stages of change that patients go through.

They also need to be empathetic, sensitive to patient needs and have good communication skills in order to extract information that will help manage the patient. They should be trained in safeguarding and be alert to information that should be passed back to the primary care team or escalated to the appropriate agency.

A social prescriber also should be knowledgeable about the geographical area they serve, work well in the primary care team and be comfortable attending meetings and sharing information as needed.

NHS England sets out the minimum requirements for a social prescribing link worker employed by PCNs, in the NHS England Network Contract DES service specification.

Getting the best out of your link worker
Help them to help you
Invite your social prescribing link worker to regular MDT meetings. This is the best way for them to identify patients they can help. This will also help the social prescriber identify what other agencies are involved and whether their involvement may duplicate work or cause extra steps or inconvenience for patients.

Encourage regular communication
Presence at team meetings also encourages sharing of information and the likelihood that the service will be used, as it helps other healthcare professionals in the team identify needs and potential support available. It will also enhance relationships with other team members and break down potential barriers to communication.

If you do not have a regular MDT meeting, ensure you introduce the link worker to your team or directly to individual team members. It is important that everyone in your team is aware that there is a link worker available, particularly care navigators whose roles may partly overlap.

Co-ordinate with PCN colleagues
It is important to co-ordinate with other member practices where link workers are employed across a PCN. For example, if MDT meetings at different practices are held the same day, a link worker could be invited at least once a month, or where there are multiple link workers they can be assigned to different practices.

A regular (monthly) newsletter via email, highlighting case studies with positive outcomes, is also useful to keep up their profile and share knowledge and information about the service.

Have clear referral pathways
This can be through email, task or referral form. It is also important to have a clear and formalised process for the link worker to communicate back to the referring clinician. Also remember when referring to use the code ‘referred to social prescribing service’.

Make sure they feel supported
There have been concerns that social prescribing link workers feel undervalued and lack support in their new PCN roles. One survey conducted in 2020 found 30% of link workers were considering quitting because of a lack of clinical supervision or support. Most of them were based in general practice.

I suspect much of this was down to poor understanding of the support and skill they can provide, so that teams are not referring patients appropriately. It is vital your link workers are invited to MDT meetings and kept in touch with the rest of the team.

It may not be necessary to have a formal supervision process, but it is important your link workers have a clinician they can speak to, or the practice manager, to discuss any queries or concerns.  In addition, encourage link workers in a PCN to meet regularly to discuss cases and support each other. This could involve a group on social media, such as Facebook, WhatsApp or Twitter.

You could also encourage them to join an organisation such as the National Association for Link Workers, to network with other social prescribers to share experience, knowledge and training opportunities.

Dr Pipin Singh is a GP partner and trainer in Wallsend, Tyne and Wear

To access a fuller version of this article, visit pulse-intelligence.co.uk