SPLENDID: Social Prescribing for people living with dementia

UK General practice is struggling. It is overwhelmed and under-resourced. Patients, practitioners and policy makers alike feel frustrated. People are looking for new ideas. One idea introduced by NHSE in 2020/21 is the idea of Social Prescribing.

Social Prescribing recognises that many of the issues affecting people’s everyday health are not medical. If we want to improve the health of individuals and communities, we need to recognise and address the range of so-called social determinants of health. These include issues about housing, eating, social contacts, work and employment, environmental issues.

By introducing Social Prescribing, NHSE aimed to introduce new services to help connect people with local expertise and resources in their communities that can help with health related needs, but ones that don’t need medical care. The goal was to improve the health of local communities, and reduce the demand on formal health services.

Social Prescribing is nothing new – although the name has changed over many decades. GP practices have been working with their local communities for decades to support the extended health needs of their local populations. But the introduction of a formal Social Prescribing service into the primary healthcare setting has created some important opportunities and challenges for patients, clinicians, communities, and health service managers.

We have been involved in primary care research in this area for a long time. The Academy of Primary Care continues to support a range of Social Prescribing research projects as part of our broader focus on advanced medical generalist care, workforce development and primary care redesign.

SPLENDID is one of our portfolio of projects which look at the work, workforce and impact of social prescribing.

In 2019 dementia affected 885,000 people, and this is predicted to increase to 1.6 million by 2040. Supporting people living with dementia (PLWD) and their families is a priority for the NHS and for health services research.

People living with dementia (PLWD) experience a range of health problems, some related to the underlying cause of their cognitive decline (e.g. cardiovascular conditions), and a decline in mental, psychological, physical and spiritual health. These multifaceted and complex needs are exacerbated by social isolation and difficulties in accessing support and care resulting in burden which often falls heavily on family carers.

With the introduction of new Social Prescribing (SP) initiatives, this project looks to critically examine if and how we can use SP to help support people living with dementia and their families and carers. Our set up work highlighted a number of areas we would need to focus on in this work. These include understanding how we can best support Link Workers to work with this community, and support their extended needs. How we can ensure that SP initiatives improve and not worsen the known health inequalities faced by people living with dementia. And how we can best integrate SP into everyday general practice. These patients will need continuing medical support and SP so how do we help these services work together

This research has strong links with other projects within our team – including the LINK WORKER study with Dr Tierney and the TIMES study looking at strengthening advanced generalist care for people living with dementia.

This research is funded by NIHR PGfAR 203280.

The project is at the scoping and development stage as we work to develop a new complex intervention.

We’ve been mapping how SP for people living with dementia is being rolled out across the country. We’re gathering the views and experiences of patients and staff. We’ll use all of this in a series of co-design workshops to develop and describe a novel SP approach targeting people living with dementia. Which we’ll evaluate ina full clinical trial

Our work to date is highlighting the variability and complexity of SP provision and the specific additional challenges when working with people living with dementia. Findings which resonate with our Link Worker study. Next we’ll work to describe some practical/applied responses.