ID-5184 Wonca Abstracts supplement A-K 13-10-23 - Flipbook - Page 122
WONCA 2023 Supplement 1: WONCA 2023 abstracts (A–K)
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What does social prescribing look like in practice?
A qualitative case study informed by practice theory
Dr Sara Calderón-Larrañaga1, Trish Greenhalgh2, Sarah Finer1, Megan Clinch1
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Wolfson Institute of Population Health, Queen Mary University of London, 2Nuffield Department of
Primary Care Health Sciences, University of Oxford
Background
Social prescribing (SP) typically involves linking patients in primary care with a range of local,
community-based, non-clinical services. While there is a growing body of literature investigating the
effectiveness of SP in improving healthcare outcomes, questions remain about how such outcomes
are achieved within the everyday complexity of primary healthcare and community services.
Methods
This qualitative case study, informed by practice theory, aimed to investigate how SP practices
relevant to people at high risk of type 2 diabetes (T2D) were enacted in a primary care and community
setting serving a multi-ethnic, socioeconomically deprived population. Different types of qualitative
data were collected, including 35 semistructured interviews with primary care clinicians, link workers
and SP organisations; 30 hours of ethnographic observations of community-based SP activities
and meetings; and relevant documents. Data analysis drew on theories of social practice, including
Feldman’s notion of the organisational routine, which emphasises the creative and emergent nature
of routines in practice.
Results
Different, overlapping ways of practising SP were identified: from highly creative, reflective and
adaptative (‘I do what’s best’), to more constrained (‘I do what I can’) or compliant (‘I do as I’m told’)
approaches. Different types of practices were in tension and showed varying degrees of potential to
support patients at high risk of T2D. Opportunities to adapt, try, negotiate and ultimately reinvent SP
to suit individuals’ own needs facilitated adoption and successful SP implementation, but required
specific individual, relational, organisational and institutional resources and conditions.
Conclusion
Creative, reflective and adaptative practices facilitated ‘good’ SP, but required specific resources and
conditions to be enacted.
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