Exploring the challenges of link workers: the 'make or break' element of social prescribing
Breaking down a crucial element to social prescribing success
Social prescribing schemes are typically broken down to three stages:
Referral from healthcare provider
Assessment by ‘link worker’
Referral to community organisation or group
The role that the link worker plays is varied, complex and challenging. As this excellent guide [PDF] outlines, link workers need to be good at engaging with healthcare workers, patients and community organisations. They need to be empathetic, patient, excellent communicators, able to manage heavy caseloads, possess motivational interviewing capabilities, good at collecting data, knowledgeable about governance, and sensitive to the needs of their clients.
That is one challenging role. It’s clear that almost the whole process and responsibility for successful outcomes rests on the shoulders of the link worker.
What are the link worker’s key roles? And are there ways to fulfil these roles in a rigorous, consistent and sustainable way?
These are the questions we’ve started to explore below:
1. Assess Social Needs
Understanding the person’s individual situation, needs, personality and ‘social preferences’ is important to inform any social referral. This step might benefit from a considered and structured methodology, rather than simply relying on individual skills of the link worker. Some form of social needs assessment framework, potentially supported by software/technology, could provide much-needed rigour and consistency.
2. Source Social Opportunities
Finding appropriate social and community activities for the individual is a complex and fraught task. In the U.K most emphasis is on making referrals to the voluntary, community and social enterprise (VCSE) sector. This provides the necessary governance structures and a degree of confidence that the individual will be properly supported. However it is unclear what matching methodology is in place that caters to the unique needs and preferences of the individual. Different ages, degree of disconnection, level of confidence, personality type (i.e. introvert vs extrovert) and many factors will be determinants of a successful match.
The flip side of any social needs assessment needs to be the supply of a variety of social opportunities that match up to different people’s needs. Achieving this in every local area while solely relying on existing community organisations is a very difficult task. It might likely require a broader, blended approach of sourcing and creating suitable opportunities - in effect, building some new social infrastructure.
3. Manage Social Participation
Once the conditions for a successful referral are there (i.e. social needs have been assessed and matched to a suitable activity), there still exists the challenge to ensure the person’s participation. This role could be broken into several components: an introduction, potentially some type of trial or onboarding, regular participation, and then subsequent tracking. Beyond the persistence and dedication of the link worker, there are a range of tools and approaches to support individual activation and engagement.
From linking to… matchmaking?
Each of these three key elements of social prescribing is complex and challenging. If there was an available army of superhero link workers, successful social prescribing might be easier to achieve. Instead, we are presented with a series of sticky design problems. How do we conduct rigorous social needs assessments? How do we ensure the supply of social activities matches the needs of the individual? And how do we activate and engage individuals in the ongoing experience of social activities?
Social prescribing involves many links in a chain which means many points of potential failure. Perhaps the social prescribing challenge is more akin to matchmaking than simply linking. A strategic and considered design solution - involving collaboration, stakeholder input, constant iteration and careful validation - is very much in order.
We’ll be sharing some points for consideration and discussion shortly. Stay tuned.