Awareness and appropriateness of social prescribing
“Initially a lot of the role was explaining what the role is.”
Link Workers shared that it has taken time to establish their services. Being embedded in multidisciplinary teams can help clinicians to understand what social prescribing is and how it supports young people. Furthermore, clearly communicating what a Link Worker can do and having a triage or holistic assessment of referrals can reduce inappropriate cases.
“Having a clinician who knows what social prescribing is, I think personally it does have a massive impact.”
Co-designing services
Involving young people and parents in the design of services is seen as hugely beneficial – the idea of “nothing about us, without us”. Whilst the extent to which this is currently happening varies, there are some promising examples.
“Young people are involved at kind of every step and every change that we make is often because of young person’s feedback.”
Workloads
Caseloads vary considerably from 10 to 50 people, with many reporting a caseload of 20-25. Offering 6 sessions, or up to 12 weeks, is common, with some wiggle room. Session flexibility is important for engagement and goal achievement.
“The reason why we’re flexible with sessions is because it depends on what the goal is for the person that we’re working with.”
Having time (especially early on) for community asset mapping is also important for Link Workers to be effective in their roles. Some Link Workers also spoke of the benefits of building good relationships with local schools, to help enable social prescribing with a young person.
Link Worker support
Clinical supervision is valued, but the extent to which Link Workers get it is varied. When clinical supervision does happen, this is usually every 4-6 weeks. Other types of support include line management, multidisciplinary team meetings and safeguarding support.
“I’ve been in the job six months and I’ve not had a clinical supervision at all.”
”There’s like absolute wrap around support. It’s really, really been great from my perspective.”
There are a lack of specific policies or procedures for social prescribing with young people, which remains an obstacle.
“I feel like we’re often like hodgepodging together stuff that’s like relevant and transferable, but not precise to social prescribing.”
Training
Link Workers undertake mandatory training (e.g. safeguarding), as well as more specific training which differs by location and local youth need. For example, this could include topics such as autism, self-harm and motivational interviewing.
Looking forward, several Link Workers were interested in undertaking emotional resilience training to help manage their own wellbeing, as well as defensible documentation training to improve record keeping.
Personalised care budgets
There is mixed access to personalised care budgets to help address health inequalities and support social prescribing. When available, budgets are often £30-40 per young person and can be spent on things like sports equipment, a class or first month’s membership fee to an activity. The ability to tie into other funding for children and young people, such as EHCP plans, or to negotiate a deal can also be beneficial for covering ongoing costs.
“As social prescribers, we find that we’re kind of masters of a freebie. I think because of so, so much of what we do is relationship based, like with the young people and with connections with the community.”
Outcome measures
Finally, finding appropriate outcomes measures is a challenge. Link Workers often use wellbeing measures or outcomes rating scales but would like to see an easy to use, universal questionnaire to capture change.
“I would absolutely love there to be something universal that that all services are using because I think it is a real gap.”
