PurposeSocial prescribing supports people with complex needs to improve social, physical and mental well-being. While dementia is mentioned in UK social prescribing policy documents, there is no implementation guidance. People with dementia have complex health and social care needs, and support is available from community-based initiatives (third sector). Many people may struggle to access support, and social prescribing could have a role in bridging this gap. Evidence is needed to demonstrate benefits and identify additional training for link workers to address specific needs of people with dementia. Design/methodology/approachA systematic search was conducted of four academic databases and grey literature. Inclusion criteria included description of link worker and person-centred care planning. Findings126 articles were identified and screened, leading to the selection of 6 articles. Quality appraisal found variable quality of reporting, with study types including survey, qualitative and mixed methods. Our analytic framework was derived from an international consensus study of social prescribing. Each theme was evidenced in our selected studies: referral route, link worker, person-centred care plan and access to resources. Evidence was limited on the role played by link workers. We noted an absence of discussion of how dementia-related impairments may require special training for link workers or additional resources. Originality/valueIn this first review of social prescribing for dementia, we found only a small number of studies. Our analysis has identified gaps in knowledge about social prescribing and, in particular, whether modifications are required in order to provide optimal support for people with dementia.
PurposeAmid increasing interest and investment in interventions that produce positive childhood experiences (PCEs), our goal was to develop, implement, and evaluate a social prescribing program for children and youth in an underserved community. This paper outlines our program development, implementation, and evaluation efforts.Design/methodology/approachOur program was based in a social paediatric hub in Ottawa, Ontario, Canada. Following an eight-month period of program development, we launched the program in May 2023 and conducted a ten-month pilot, with an embedded program evaluation and knowledge mobilization strategy. The evaluation drew on sociodemographic and electronic medical record data, semi-structured interviews with participants, caregivers, hub staff, and community partners, and an open-ended survey for medical trainees. Central to this work was a shared commitment to community engagement, health equity, and quality improvement.FindingsDuring our ten-month pilot, we served 43 children and youth between 4-17 years of age (mean = 10 years of age). There was a high proportion of males (n = 27; 63%), people whose first language was not English or French (n = 16; 37%), Francophones (n = 14; 33%), people born outside of North America (n = 18; 42%), newcomers (n = 15; 35%), ethnic and racial minorities (n = 33; 77%), and people with disabilities (n = 32; 74%). Participants came from families facing multiple socioeconomic barriers. Altogether, participants completed 230 sessions with their connector and co-produced 148 social prescriptions, spanning six different categories: (1) Arts and culture (n = 62); (2) Physical activity (n = 37); (3) Time in nature (n = 16); (4) Career exploration (n = 13); (5) Practical skills (n = 11); and (6) Entertainment and leisure (n = 9).Originality/valueThis work makes a novel contribution to the social prescribing literature. It offers a detailed account of our program development, implementation, and evaluation efforts and extends the limited evidence base on paediatric social prescribing.
Purpose Integrating health and social care services is a longstanding aspiration in England, but the question remains as to how to achieve it. This article compares the implementation approaches and its enablers and barriers of a strengths-based intervention (community-led support, CLS) in two sites, one led by a health organisation, i.e. National Health Service (NHS) and the other by a social care organisation, i.e. local authority.Design/methodology/approach This study was part of a wider research project that examined the implementation of CLS within five areas in England. A qualitative research design was adopted, drawing on seventeen semi-structured interviews with managers and frontline staff leading the implementation of CLS across health, social care and voluntary sector organisations. Data was analysed inductively for each site before comparing emerging codes between the sites.Findings Supportive leadership structures at various levels, a shared vision, pre-existing relationships with other sectors and introducing champions were helpful factors to adopt CLS. However, staff anxieties towards creative ways of working, the lack of involvement of individuals with lived experience and the insufficient integration of processes and systems hindered embedding CLS across the whole system.Originality/value Emphasis on a community oriented approach encourages local innovation based on the needs of a community. This study provides helpful insights into aspects supportive of implementation while highlighting unique challenges arising from integration.
Purpose - This study examined the structural factors affecting the patient-reported quality of Sickle Cell Disease (SCD) care at the Ghana Institute of Clinical Genetics (GICG), providing evidence to inform health system improvements, policy, and chronic disease management strategies. Design/methodology/approach - A cross-sectional study was conducted at the GICG between September and October 2023. A self-developed structured questionnaire captured data on socio-demographic characteristics, structural factors (including facility accessibility, availability of essential medicines, and health financing options), and patient-reported quality of care. Data were analysed using STATA 17.0. Descriptive statistics summarised participant characteristics, Pearson's Chi-square explored bivariate associations, and multivariable logistic regression identified factors independently associated with care quality at p < 0.05. Findings - The study achieved a 100% response rate with 424 participants. Most respondents were females (67.4%), aged 20-29 (37.5%), had SS genotype (51.9%), and used hydroxyurea (68.6%). Overall, 81.8% of respondents rated their care as good. Significant predictors of good quality care included age, hydroxyurea use, facility accessibility, and health financing options. Research limitations/implications - The single-centre, convenience sampling and reliance on self-reported data may limit generalisability. Future multi-centre studies exploring mixed methods and incorporating provider perspectives are recommended. Originality/value - This study provides empirical evidence linking structural determinants with the quality of SCD care in Ghana. Findings are contextualised within national, regional, and global frameworks, offering actionable insights for improving chronic disease management in low- and middle-income countries (LMICs).
Purpose The need to find practical solutions for integrated care is continuously sought after by policy makers and practitioners. Yet experience tells us that the collaboration needed for integrated care is far from easy. A central issue that arises is often how collaboration is framed, where the ambiguities and uncertainties surrounding the term can gloss over an array of ideas, concepts and mechanisms. Paradox and tensions are often inherent in collaborative working and in this Viewpoint we contemplate how competing metaphors of collaboration have direct relevance to the current integrated care system landscape in England. The review presents these metaphors before going on to assess the leadership implications for those currently engaged with leading collaboration across integrated care settings. Design/methodology/approach Drawing on policy and practice evidence from the current integrated care system landscape in England, our Viewpoint draws on the tradition of metaphorical analysis and identifies three metaphors that capture how collaboration is currently being understood and enacted within the context of integrated care systems (ICSs). Findings Our analysis shows that metaphors of efficiency, ecology and mimicry illuminate the paradoxical and dynamic nature of integrated care agendas. Practical implications Within the context of integrated care, leadership success will require managing the tensions or dualities of collaboration, reconciling the coordination and engagement with populations and places alongside the demands of market efficiency and government mandates to conform and comply. Social implications Given the pressures being faced across ICSs, the bandwidth to strategise and reflect on any metaphorical tension and paradox remains an extremely challenging one. However, by encouraging a metaphorical mindset, the aim of this Viewpoint is to support leaders by unearthing the mental models that are driving system behaviours. It encourages those leading integrated care agendas to see the less visible forces at work, and provide opportunities for learning and development for workforce and population groups. Originality/value We argue that by engaging with metaphors and metaphorical mindset, leaders are better able to understand the characteristics and consequences of collaboration for integrated health systems. The art of leading integrated care is rooted in the ability to combine metaphors in a language and framing for collaboration to develop. We provide practical implications for training and development agendas and call for further research to better understand the translation of metaphors across workforce and population groups.
Purpose - Type 2 Diabetes Mellitus (T2DM) is a chronic metabolic disorder frequently accompanied by psychological comorbidities such as anxiety, which may be adversely correlated with glycemic control. Psychosocial factors, including perceived social support and quality of life (QoL), are known to correlate with these outcomes. This study investigates the association between social support, QoL, anxiety, and glycemic control among patients with T2DM. Design/methodology/approach - A cross-sectional study was conducted among 103 patients with type 2 diabetes mellitus (T2DM) who were purposively selected from a primary healthcare facility. Data were collected using the Multidimensional Scale of Perceived Social Support (MSPSS), the Diabetes Quality of Life questionnaire, the Hamilton Anxiety Rating Scale and random blood glucose measurements. Cross-tabulation and Spearman correlation were performed to examine correlations between variables. Findings - This study reveals that higher levels of social support are significantly associated with lower anxiety (p < 0.01). Similarly, better QoL showed a negative correlation with anxiety levels (p < 0.01). Furthermore, elevated anxiety scores were positively associated with increased blood glucose levels (p < 0.05). Originality/value - The finding of this study confirms that enhancing social support and QoL might mitigate anxiety and be associated with glycemic control among T2DM patients. These findings highlight the importance of incorporating psychosocial interventions into diabetes management programs at the primary healthcare level in the Indonesian context, and they may be associated with both mental well-being and glycemic control.
PurposeContext is increasingly recognised as a central determinant of whether integrated care interventions succeed or fail. Yet the proliferation of contextual analysis frameworks with different epistemological perspectives and empirical applications has created uncertainty about how to make sense of context in complex health and social care systems. This paper critically compares thirteen influential frameworks to examine how they conceptualise, assess and operationalise context for integrated care implementation. Design/methodology/approachA structured and theory-informed comparative analysis was undertaken. Frameworks were purposively selected based on relevance to health and social care, conceptual clarity, empirical use and applicability to complex or multi-level settings. Each framework was examined across five analytical dimensions: epistemological foundations, conceptual structure, methodological guidance, empirical application and relevance to integrated care. An interpretive synthesis approach enabled cross-framework comparison without collapsing diverse paradigms into a single model. FindingsFrameworks varied substantially in their assumptions about knowledge, causality, and system behaviour. While tools such as CFIR and Theoretical Domains Framework offer structured and widely used taxonomies, newer frameworks; including ICON, CICI, NASSS and the Context Coding Framework, better reflect the dynamic, relational and cross-boundary nature of integrated care. Participatory and realist approaches add value through attention to mechanisms, reflexivity and power, but often lack procedural guidance. No single framework fully captures the multi-level and emergent properties of integrated care systems highlighting the need for purposeful combination rather than substitution. Practical implicationsThe analysis highlights the need for hybrid and adaptive approaches to contextual analysis, supported by greater epistemological awareness and attention to power, equity and inter-organisational dynamics. The paper offers guidance for selecting and combining frameworks depending on purpose, stage of implementation and system context. Originality/valueTo our knowledge, this is the first study to systematically compare contextual frameworks through the lens of integrated care. It provides conceptual orientation and practical sensemaking to support more context-sensitive, adaptive and relational approaches to integrated care implementation.
PurposeGlobal adoption of integrated care provides opportunities for enhancing life outcomes and personalised services and addressing health and social inequality, with the attainment of these aspirations requiring specific educational interventions. This project sought to address the paucity of available interventions within the literature by presenting an effective curriculum framework for training pre-registration health and social care students to provide integrated care within the primary context of English integrated care systems. Design/methodology/approachAn action research approach developed the curriculum framework in four stages: (1) a literature review identified existing evidence available for educating students around integrated care; (2) thematic mapping of professional standards and health and social care course learning outcomes confirmed the elements required for successful practice; (3) student evaluation of the mapping outputs and perspectives on integrated care confirmed applicability to programmes and (4) conceptualisation of the final framework. FindingsThe curriculum framework comprises eight domains, each containing competency requirements to achieve the overall outcome aligned to successful practice in integrated care and within integrated care systems. The presented framework provides the overall thematic outcome for the domain and the learning outcomes required. The framework is centralised by person-centred care as a hallmark of effective practice and commitment within integrated care. Research limitations/implicationsThe framework offers a tailored approach to educating undergraduate health and social care students around integrated care and working within integrated care systems. Practical implicationsThe framework offers a new and novel mechanism for training the future workforce in integrated care and for working in integrated care systems. Originality/valueThe integrated care curriculum framework offers an opportunity to address the current evidence gap of interventions designed to train students for future practice in integrated care and within integrated care systems and the requirements of professional education for enhancing knowledge in the field.
PurposeSocial prescribing is reported to be less effective in rural than urban areas due to the lack of anchor organisations and fewer activities being available. We explore this by presenting a case study of community mapping within an IMPACT Facilitator project exploring loneliness with older people in a rural area of Scotland.Design/methodology/approachIMPACT is the UK centre for implementing evidence in adult social care. Its Facilitator projects engage with people who access services, family carers and practitioners to support an area of local change that also has national significance. This project adopted a participative community mapping (PCM) approach, using ethnographic methods to explore communities in more depth, and meet older people and the practitioners and volunteers who worked with them in a range of venues. We held focus groups and a world cafe to share findings and agree recommendations.FindingsPCM highlighted new activities beyond those identified in desk-based research. We found that some people and places acted as "mini anchors" in smaller isolated communities. Importantly, engaging with older directly in their community led to a deeper understanding of what they valued about these resources, and what they might wish for in the future. A weakness of PCM is that it is time intensive, however, if we wish to increase the effectiveness of social prescribing in rural areas then it might be time well spent.Originality/valueThis article provides a unique insight into how PCM might address some of the challenges that rural areas present to social prescribing.
PurposeThe compounded disadvantage for individuals with unmet social and health care needs often leads to frequent emergency presentations. In Australia, New South Wales, the Emergency Department to Community (EDC) program was devised to support intensive care coordination for patients with complex care. With a lack of qualitative evidence, the aim of this study was to explore the barriers and facilitators of forming, implementing and sustaining partnerships with EDC stakeholders in four local health districts: Sydney, Central Coast, South Eastern Sydney and Murrumbidgee. Design/methodology/approachData collection (March–July 2025) comprised documentary analyses of EDC documentation and interviews and focus groups with stakeholders, the allied workforce and community providers. Approvals were obtained, all data were de-identified and data saturation was achieved. Thematic analysis was undertaken pragmatically within the School of Strauss and Corbin. An adapted version of Wodchis's policy framework was applied to assess subtheme alignment and sustainability of EDC partnerships. Triangulation between data sources was undertaken, and a roundtable was held to verify findings. Governance was provided by a steering committee with representatives from LHDs. FindingsIn total, 48 documents and 53 interview/focus group data were analysed. Four key themes are described: EDC patients have diverse complex needs and deep mistrust in the system. Multidisciplinary working and collaboration through cross-sectoral meetings, emergency department (ED) management plans and technological systems helped break silos and connect care across settings. Hidden work, which is not captured in data metrics, was often led by program champions and generalists that build rapport and bridge gaps in care coordination with multiple specialists. The impact of EDC was consistently echoed as “great” with staff satisfaction and a perceived reduction in ED presentations. Originality/valueThe EDC program delivers trauma-informed care for people with complex needs who are excluded from standard care models. Hidden labour and generalists are critical in building connections and rapport with specialists across health and social sectors. The program’s policy and social impacts align with equity, supporting the quintuple aim and sustainable development goals by prioritising support for the most disadvantaged groups.
PurposeThis paper examines how third-sector organizations and volunteers are integrated into health and social care through the development of Family Centers (FCs) in Brescia, Italy. It investigates the structural, operational, and cultural conditions that shape collaboration between third-sector actors and socio-health professionals, identifying barriers and facilitators that affect service co-delivery. The study also explores the co-delivery strategies used to clarify mandates, strengthen referral and information flows, and sustain multi-actor collaboration within an established service ecosystem. Design/methodology/approachThe study used a multi-phase qualitative design combining a targeted literature review with empirical inquiry in the Brescia Family Centers. Data were collected through twelve semi-structured interviews with socio-health professionals and third-sector actors involved in FC planning and delivery (April–July 2024). Interviews were audio-recorded, transcribed verbatim, and coded in NVivo. Findings were developed through abductive analysis and refined by considering negative cases. To validate and deepen interpretation, the interview synthesis informed three participatory workshops that supported collective reflexivity and helped consolidate barriers, facilitators, and co-delivery strategies across the service ecosystem. FindingsFindings show that integrating third-sector partners into the FC model depended on resolving structural, operational, and cultural conditions. Key barriers included a weak FC identity due to the lack of a distinct space and dedicated staffing, role overlap with Counseling Centers, and fragmented coordination across actors and case follow-up. Cultural resistance to non-clinical approaches initially limited the uptake of pedagogical and mediation roles. Facilitators included multidisciplinary collaboration, rapid intake and routing through the FC’s orienting functions, calibrated engagement intensity, and culturally responsive practices that broadened support beyond clinical framings. Research limitations/implicationsThis single-case study, focused on early-stage implementation in Brescia, Italy, limits generalizability. Broader, comparative research is needed to assess long-term impacts and applicability in different contexts. Future studies should explore how hybrid governance evolves over time and examine measurable outcomes of third-sector integration in health and social care systems. Practical implicationsThe findings offer actionable insights for managers aiming to improve coordination between public services and third-sector actors. Emphasizing role clarity, structured communication, and flexibility can reduce fragmentation and enhance collaborative service delivery. Social implicationsUnderstanding how integrating third-sector organizations supports more inclusive, responsive care. This approach strengthens connections to local communities, facilitates access for vulnerable groups, and promotes shared responsibility in addressing complex social and health needs. Originality/valueThis study contributes to the growing literature on integrated care by offering empirical insights into the co-production of family-oriented services through third-sector involvement. It proposes actionable strategies to enhance collaboration and sustainability in hybrid governance models, providing guidance for policymakers, practitioners, and researchers engaged in service innovation and community-based care.
PurposeVery elderly patients with heart failure (HF) living in long-term care facilities (LTCFs) frequently experience fragmented care, avoidable emergency department transfers, and suboptimal treatment optimisation. We aimed to describe the implementation and early care delivery outcomes of an integrated cardiogeriatric pathway designed to improve coordination, clinical decision-making, and continuity of care across settings. Design/methodology/approachWe conducted a prospective, single-centre pilot implementation study in one LTCF, based on a multidisciplinary cardiogeriatric model coordinated by advanced practice nurses (APNs). The pathway integrated systematic screening, telemonitoring (Satelia® Cardio), shared electronic medical records, structured multidisciplinary reviews, and pre-activated hospital-at-home (HAH) care plans. Feasibility indicators, care delivery metrics, and descriptive outcomes were prospectively collected. FindingsAmong 76 residents screened, 22 patients were enrolled. Telemonitoring was implemented in 10 patients (45.5%). Five patients (22.8%) benefited from cardiogeriatric day-hospital assessment, and two (9.0%) underwent on-site treatment titration. Anticipatory care planning included the pre-activation of a dormant HAH file for diuretic management in 20 patients (90.9%) and a palliative care HAH file in 11 patients (50.0%). The pathway enabled individualized, coordinated care adapted to patients' clinical status, frailty, and goals of care. Practical implicationsThis pilot demonstrates the feasibility of an APN-coordinated, integrated cardiogeriatric pathway for HF management in long-term care, combining telemonitoring, anticipatory care planning, and cross-setting coordination. Originality/valueCARE-HOME-HF represents a novel, scalable model operationalising European recommendations for multidisciplinary, function-centred care in very old adults and corresponds to the feasibility stage of the UK MRC framework for complex interventions.
PurposeFor lifestyle disorders like PCOS, health professionals play an essential role in the patient's compliance with the treatment and their well-being. However, there is little data exploring the qualitative experiences that women with PCOS in India have with respect to their clinical encounters. This paper attempts to fill this gap. Design/methodology/approachThe study includes 15 women diagnosed with PCOS and seeking treatment in the Government Yoga and Naturopathy Medical College & Hospital in the south Indian city of Chennai. Data was collected using -depth interviews and was analyzed using the six-phase thematic analysis approach as the frame of reference. FindingsWomen reported that during clinical consultations, doctors primarily focus on prescribing medicines, followed by advice about lifestyle modifications such as weight reduction. Yet, women experienced several challenges in making these lifestyle changes, which went unnoticed by the doctors, due to doctors' emphasis on prescriptive communication rather than listening. Originality/valueThis paper highlights how the conventional paternalistic doctor–patient relationship is not enough to bring lifestyle changes in patients and hence needs to be replaced by a holistic multidisciplinary perspective guided by the principles of integrated care to effectively deal with a lifestyle disorder like PCOS.
PurposeThis study aims to bridge policy gaps in Albania's foster care system by adopting a bottom-up approach that captures foster parents' perspectives on the implementation of family-based alternative care. The study explores inconsistencies in the legal framework, bureaucratic procedures and limitations in human and financial resources of foster care, within the broader context of child protection, public health and deinstitutionalization reforms.Design/methodology/approachThis research applies participatory research to engage in policy dialogue with the interested group and civil society organizations of the Draft Law on Family-Based Alternative Care. The instrument was a focus group discussion with seven non-relative certified foster parents, out of a total of nine certified foster families in Albania.FindingsThe foster family discussions are related to four main thematic areas: (1) pathways to permanence, (2) navigating legal and administrative barriers, (3) family support and reunification and (4) role of institutions. The findings reveal that without coherent implementation, the new law risks reproducing the fragmentation of foster care services and the child protection system in Albania.Social implicationsThe findings highlight the need for greater political and societal attention to children without parental care in Albania. They also underline the importance of strengthening training and cooperation among foster families, biological families, and child welfare professionals to support the effective implementation of foster care services.Originality/valueThis research provides the first qualitative evidence from foster parents during the legitimating process in Albania, offering practical insights for policymakers on translating legal provisions into effective services for children. It might be a contribution to the international debates on strengthening family-based alternative care for children without parental care.
Purpose-In a recent paper in this journal, Clark et al. (2024) discuss insights from applying a sociologically grounded relational theoretical perspective to understanding integrating care. That paper formed the focus for an ongoing discussion between the authors of this paper about relational theories. Two of the authors have drawn on a Gestalt theoretical tradition to develop a Relational Organisational Gestalt perspective to understanding organisations. In this article, we continue the dialogue the authors have developed across the sociological and Gestalt relational perspectives and how these apply to understanding integrating care. Design/methodology/approach-In this article, we consider the sociological and Gestalt relational perspectives and their application to understanding the process of integrating care. We discuss key conceptual elements of both approaches and their overlaps, and how these can be directly useful when organising for integrating care. Findings- A sociological relational perspective and a Gestalt (particularly relational organisational Gestalt) one share key conceptual concerns. These include the primary focus on relations as the fabric of social phenomena, the ongoing flow and emergence from complex social webs of interactions, including people's identity. This leads to a different perspective on understanding integrating care, namely one focused on it as an ongoing process rather than an end state of correct organisational arrangements. Applying these fundamental insights to managing integrating care can be disconcerting, especially in an ideological environment emphasising individuals, hierarchy and control. However, the conceptual tools of the relational perspectives discussed can be useful in navigating integrating care. Research limitations/implications-The sociological relational and Gestalt perspectives have many similarities which bring helpful perspectives to understanding integrating care. Although this article emerges from a dialogue amongst the authors, it is grounded in many years of experience of thinking about and applying the relational perspectives set out here. Adopting these perspectives will guide a research agenda for integrating care. More empirical work is required to further develop the evidence base for relational understanding of integrating care. Practical implications-We highlight practical insights and lessons from these relational perspectives for understanding and managing integrating care. Originality/value-This is the first article examining the links between the sociological perspective and Gestalt relational perspectives and their application to integrating care. From discussing these perspectives, we highlight conceptual and practical approaches to understanding and managing integrating care.
PurposePolicies that support joint access to and responsibility for funding increase participation in integrated care. However, knowledge regarding funding systems employed in integrated health and social programs are underreported. We seek to understand the different funding models in health and social care services in the Sydney Metropolitan, Australia.Design/methodology/approachQualitative interviews were designed to map current funding models in integrated health and social care programs aligned with the Wodchis Policy Supports Framework.FindingsWe reviewed 24 local health and social programs. Innovative models of funds for piloting new initiatives at health programs are emerging (e.g. research grants with in-kind contributions). Two health programs had combined funding from social and health funders employing agreements as policy support. Social programs drew more on diverse funding sources than health programs. The health sector supports social care via the commissioning of services through state and federal health agencies.Practical implicationsThe landscape of funding models for both health and social care is complex. We demonstrate that systems are adopting pooled funding and entering to agreements to reduce fragmentation. There is an opportunity to build robust systems to expand integrated funding and sharing of control of funds, given the existing collaborations and partnerships highlighted in this study.Originality/valueIn this paper, we contribute to building a stronger body of knowledge on the different funding models currently used in integrating health and social care services in local systems. We explore the joint control nature of funds and the type of funding systems employed, which is underreported and rarely described in academic literature, evaluations and public reports.
PurposeThe flexible assertive community treatment (FACT) teams employ peer support workers (PSWs) and have been swiftly introduced in mental health services. PSWs contribute with experiential knowledge to the team. Earlier research lacks information on PSWs' performance in FACT teams and how experiential knowledge influences the team.Design/methodology/approachA total of 24 interviews with FACT team members were conducted to gain insight into the use of the PSWs' experiential knowledge in urban FACT teams in Norway. Reflexive thematic analysis was applied to analyze the data.FindingsThe analysis generated four main themes. Two themes highlight the content of the PSWs' performance of experiential knowledge, together with the patients. Creating respite through activities and connecting patients to their senses helps them find coping mechanisms. The other two themes revolve around how the PSWs influence the team and work with time, flexibility and tacit knowledge of recovery.Practical implicationsIntegration of PSWs' experiential knowledge requires structural and cultural conditions that support autonomy, trust and explicit role clarification. Amplifying the team's knowledge of the PSW's work with patients could improve their working conditions and give valuable information in patient treatment. Recovery-oriented collaboration can be improved by making tacit knowledge visible and valued. There is a need for further research and development on how PSW experiential knowledge is used on a group level to support recovery in FACT teams.Originality/valueThis study adds to the practical knowledge of what, why and how PSWs use experiential knowledge with the individual patient and how they can use that knowledge in team discussions.
Purpose This study aims to explore the employment destinations and professional registration of dual-qualified nurses and social workers in England. Design/methodology/approach An exploratory cross-sectional survey design was used. An online survey was conducted between July and August 2024 with graduates of integrated nursing and social work programmes in England. Data were analysed using descriptive statistics and thematic analysis. Findings In total, 82 participants completed the survey. Most participants (85.4%) had never held a role explicitly requiring a dual qualification, yet 79.3% reported applying their dual-qualification skills in practice. Dual-qualified nurses and social workers were employed in roles across multiple sectors, particularly within integrated care contexts such as learning disability, mental health and integrated discharge services. Most current roles required Nursing and Midwifery Council professional registration (52.4%), with fewer requiring both (25.6%) or Social Work England only (18.3%). Practical implications The findings suggest that dual-qualified nurses and social workers contribute valuable skills across the health and social care workforce, even when not in formally recognised roles. Findings highlight the need for greater recognition of dual-qualified roles within health and social care organisations and the development of integrated roles that fully utilise the combined skill set of these professionals. Originality/value This study offers the first empirical insight into the employment destinations and professional registration of dual-qualified nurses and social workers in England. It strongly supports the case for explicitly recognising and promoting dual-qualification pathways as a strategic component of integrated care workforce development.
PurposePersonalized prehabilitation for surgery can be delivered through social prescribing. Worthwhile Waiting (WW) is a novel health and wellbeing coaching prehabilitation primary care intervention for patients referred for hip and/or knee orthopaedic procedures. This study aimed to determine the feasibility, suitability and acceptability of WW.Design/methodology/approachThis mixed-methods single-arm feasibility design study had two components: a trial component of patients recruited from five sites and undertaking WW. Outcome measures were completed at baseline and 3 months. Trends in descriptive statistics and effect sizes for outcome measures were evaluated, and a power calculation was performed. A qualitative component comprised semi-structured interviews (n = 12) with patients and staff about WW. Qualitative data were thematically analysed. Findings were evaluated against success criteria.FindingsThirty four participants (n = 34) were recruited. All success criteria were met. An average of five participants were recruited per month. A WW champion to engage staff and a written plan or taster sessions were recommended. Positive trends were observed for most outcome measure and a sample size was calculated for a full trial. Good relationships with partner organisations and understanding their services made WW feasible. Activities needed to be accessible to be suitable. Interventions were acceptable; patients valued activity participation and conversations and access to information which the staff provided.Originality/valueSocial prescribing by health and wellbeing coaches in primary care for patients waiting for hip and/or knee orthopaedic procedures is feasible, suitable and acceptable in this study.
Purpose-This paper aims to challenge the prevailing focus on "social prescriptions" in social prescribing research and practice and argue for a broader understanding of "social prescribing" as a process of co-creation that prioritizes relationships, community engagement and self-determination. Design/methodology/approach-Rather than presenting new empirical data, this paper draws upon key concepts from public health, sociology and political ecology to offer a novel theoretical lens through which to understand and implement social prescribing, critically examining the limitations of framing social prescribing primarily through the lens of "social determinants of health." Findings-We argue that a narrow focus on "social prescriptions" over processes of "social prescribing," like a narrow focus on "social determinants of health" over complex and intersecting "processes of determination in health," can lead to a commodification of interventions, reinforce power imbalances and neglect the crucial role of community engagement and self-determination. We propose a place-based, person-centred, politically aware approach that emphasizes the dynamic interplay of people, power and place in shaping health outcomes. Research limitations/implications-This conceptual paper primarily focuses on theoretical challenges to existing social prescribing frameworks. Further research is needed to connect this framework with the existing empirical evidence and real-world practice of social prescribing, investigate the nuances of power dynamics within social prescribing initiatives and explore the feasibility of implementing alternative approaches in diverse contexts. Practical implications-The paper advocates for a shift away from simply "prescribing" social activities and toward a more collaborative, co-creative approach to social prescribing. In practice, this means that social prescribers consider prioritizing relationships: building trust and fostering strong relationships between patients, link workers and community organizations; focusing on self-determination: empowering individuals and communities to actively participate in shaping their own health pathways; adopting a "political ecology of health" framework: considering the dynamic interplay of people, power and place in shaping health outcomes and implementing culturally safe and trauma-informed practices: addressing existing power imbalances and potential harms within healthcare. Social implications-By emphasizing co-creation and self-determination, the proposed approach to social prescribing has the potential to reduce health inequities by better addressing the social and political roots of health disparities, empower marginalized communities by ensuring their voices are heard and their needs are met in a culturally safe manner, strengthen community connections by fostering a sense of belonging and mattering and promote social justice by challenging existing power structures and advocating for more equitable social and environmental conditions. Originality/value-This paper challenges the dominant focus on "social prescriptions" by focusing on processes of "social prescribing." It introduces a political ecology of health framework that provides a more nuanced understanding of the dynamic processes that shape health. This framework emphasizes co-creation, self-determination and community engagement and highlights the importance of relationships and power dynamics in social prescribing. The paper advocates for a more equitable and transformative approach that emphasizes community leadership and strengths and better addresses the social and political roots of health inequities.
