Promotion of social prescribing from within a general practice (a pilot study)

Summary: The project will deliver a practice improvement module to GPs to highlight the benefits of social prescribing (SP). Existing community networks ('hubs') in the Huon are used sporadically by GPs. The practice improvement module will provide a streamlined method of referring patients to hubs. The project will measure the feasibility and appropriateness of this model of referral by surveying GPs at the onset of the pilot and after 6 months. The number of referrals provided and number of "completed" social prescribing interactions will be compared. Patients' self-rated social connectedness and health literacy will be measured at the point of referral and after 6 months. Community hub leaders' receptiveness of the referral pathway will be assessed by survey at the end of the pilot study period. Detail: The project is a pilot study to evaluate the feasibility and appropriateness of a GP-led SP referral model. Recent investigations by others (Judi Walker et al., unpublished) suggests that SP is loosely understood but nevertheless viewed positively and currently employed on an ad hoc basis by GPs. Phases of the study include: 1. In a SP Practice Improvement Education Module, the benefits of SP will be presented to GPs at the Huon Medical Group (HMG). GPs will be encouraged to continue referring patients at risk of, or experiencing, medical or social problems (including isolation, low health literacy, recent hospitalisation) for community-based activities. Current organisations that are imbedded in their local community will be presented as a ‘community hub’ and act as the primary contact for SP activities. One or more organisation from each geographical location (i.e. Huonville, Cygnet, Geeveston) will be designated as a local community hub. The practice improvement module will be delivered via a single face-to-face educational session by one of the research team. Follow-up email communication addressed to all attendees will be used to address questions raised during the session. Ongoing reminders and any further information associated with the project will be delivered via email, the internal electronic communication system within the practice or verbally, as best suits the circumstance. 2. GPs working at HMG in Huonville, Cygnet, Geeveston will be invited to participate in: a. a baseline survey assess their awareness of existing local services, their attitude to SP, knowledge of SP and existing referral mechanisms, and b. a follow-up survey (at 6 months) to assess the feasibility and appropriateness of the highlighted referral pathway and its perceived benefits and challenges. 3. During routine practice GPs, practice nurses, social workers and other HMG staff will identify patients who may be suitable for referral to a non-medical, community-based social activity. The decision to recommend and agree upon such activities will remain part of the healthcare worker-patient interaction. Any patients who accept a recommendation to consider these activities will then be invited to participate in this research project. Patients can accept a referral for community based social activities without participating in the research. Patients will be prospectively recruited. Following the initial discussion about SP, patients will be offered a research study pack. The study pack will contain a study information sheet, consent form, baseline survey, self-addressed envelope and a referral form to their local community hub. 4. The patient will be permitted to take the information home, have time to read it, ask questions and complete paperwork. Contact details for questions and to request assistance in completing any documentation will be included in the patient information sheets and questionnaire forms. The research team will respond and provide assistance as required. 5. Patients will then be invited to return the completed consent form permitting baseline and follow-up survey participation. Completion of the baseline survey will be requested. A self-addressed envelope will be provided (addressed to the researchers c/- the University of Tasmania). Consenting patients will continue to be accepted throughout the duration of the 6-month study. 6. The community hub staff will continue to provide their existing services, specifically, using the same methods of meeting with individuals and connecting them with community activities. There will be no alterations to their usual practice model required as part of this project. The type of community activity will be decided by the patient and hub. Community hubs will be asked to retain the GP-issued referral forms of the referred patients to assist in follow-up at the completion of the study period. Consent will be obtained from the community hub representative to participate in a survey at the conclusion of the study. 7. One of the research team will ensure there are enough study packs available in each consultation room. A count of remaining packs will be undertaken every one or two weeks, depending on level of patient visitation and access to rooms. Ongoing reminders of the program will occur weekly or more often as required. Regular contact with each hub will be maintained to ensure referral forms are being collected and filed appropriately. Patient survey and consent forms will be collected from the University of Tasmania as they are returned. 8. Examples of activities delivered directly from the community hubs include signposting to other social services (government services, not-for-profit services), transportation, skills training (food preparation, wood/metalwork), and delivery of physical/social activities, Community hubs have links within their local area that facilitate the provision of recreational activities (boardgames, chat/advocacy groups, music appreciation, book clubs), craft groups (knitting crocheting, woodwork, boat building), exercise programs (aqua-aerobics, walking, yoga), educational courses (University of the Third Age, history creative writing), and social outings.