Hospital in-reach family-centred social prescribing pilot for children with neurodisability: mixed methods evaluation with social return on investment analysis

Abstract Background Social prescribing link workers support individuals to engage with community resources, co-creating achievable goals. Most schemes are community-based, targetting adults. Vulnerable populations including hospitalized children with neurodisability and their families, could also be...

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Main Authors: Laura Gordon, Megan Hastry, Angela Bate, Katie Gordon, Emily Greaves, Simoni Dimitriadou, Tim Rapley, Anna Purna Basu
Format: Article
Language:English
Published: BMC 2025-01-01
Series:BMC Health Services Research
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Online Access:https://doi.org/10.1186/s12913-025-12329-0
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author Laura Gordon
Megan Hastry
Angela Bate
Katie Gordon
Emily Greaves
Simoni Dimitriadou
Tim Rapley
Anna Purna Basu
author_facet Laura Gordon
Megan Hastry
Angela Bate
Katie Gordon
Emily Greaves
Simoni Dimitriadou
Tim Rapley
Anna Purna Basu
author_sort Laura Gordon
collection DOAJ
description Abstract Background Social prescribing link workers support individuals to engage with community resources, co-creating achievable goals. Most schemes are community-based, targetting adults. Vulnerable populations including hospitalized children with neurodisability and their families, could also benefit from social prescribing. Aims To pilot a hospital-initiated social prescribing service for children with neurodisability and their families; to explore its feasibility, acceptability and undertake social return on investment (SROI) analysis. Methods Mixed-methods cohort study with SROI analysis. We recruited children aged < 16y with neurodisability, identified during inpatient stays, their parents/carers and siblings. Participants received link worker support for 6 months, extending beyond hospital discharge. Pre- and post-intervention pilot data covered profile of needs (Support Star), quality of life (EQ5D/CHU-9D), wellbeing (WEMWBS/CORS) and financial strain. We undertook 22 qualitative observations of family/link worker interactions and 39 in-depth interviews with families, link workers and healthcare professionals. Together these data were analysed within a SROI to establish the costs and social value generated. Results Of 48 families supported by the service, 25 were recruited to the evaluation (26 children, aged 10 m-15y; 4 siblings; 36 parents). Baseline quality of life and wellbeing indices averaged below population norms. Link workers were highly effective at supporting families (only 6/151 goals unmet). Unmet need decreased by 6 months (Support Star, p < 0.001). Families reported having felt overwhelmed when trying to adjust to new ways of life post diagnosis/discharge before link worker intervention, with little support to navigate non-medical needs. Parents, link workers and health care professionals found link worker support invaluable for making community services accessible. Families then felt more connected to their communities, and less isolated, with increased belief in their self-efficacy. Families and healthcare professionals felt that the duration of support, and eligibility criteria, should be extended. Inputs to deliver the service for 1 year (49 families) were estimated at £74,736: outcomes for the 18 families studied were estimated at a value of £205,861. Conclusion Hospital in-reach social prescribing is feasible, acceptable, and addresses a range of otherwise unmet needs of children with neurodisability and their families, showing a positive SROI. Other vulnerable patient groups could also benefit from this approach. Trial registration ISRCTN23306751 (2.8.22).
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spelling doaj-art-8f0a66067c9340c59653d831fb093dae2025-02-02T12:14:26ZengBMCBMC Health Services Research1472-69632025-01-0125112110.1186/s12913-025-12329-0Hospital in-reach family-centred social prescribing pilot for children with neurodisability: mixed methods evaluation with social return on investment analysisLaura Gordon0Megan Hastry1Angela Bate2Katie Gordon3Emily Greaves4Simoni Dimitriadou5Tim Rapley6Anna Purna Basu7Population Health Sciences Institute, Newcastle UniversitySchool of Psychology, Newcastle UniversityNursing, Midwifery and Health, Northumbria UniversitySchool of Psychology, Newcastle UniversityBiomedical Sciences Suite, Newcastle UniversitySchool of Psychology, Newcastle UniversitySocial Work, Education and Community Wellbeing, Northumbria UniversityPopulation Health Sciences Institute, Newcastle UniversityAbstract Background Social prescribing link workers support individuals to engage with community resources, co-creating achievable goals. Most schemes are community-based, targetting adults. Vulnerable populations including hospitalized children with neurodisability and their families, could also benefit from social prescribing. Aims To pilot a hospital-initiated social prescribing service for children with neurodisability and their families; to explore its feasibility, acceptability and undertake social return on investment (SROI) analysis. Methods Mixed-methods cohort study with SROI analysis. We recruited children aged < 16y with neurodisability, identified during inpatient stays, their parents/carers and siblings. Participants received link worker support for 6 months, extending beyond hospital discharge. Pre- and post-intervention pilot data covered profile of needs (Support Star), quality of life (EQ5D/CHU-9D), wellbeing (WEMWBS/CORS) and financial strain. We undertook 22 qualitative observations of family/link worker interactions and 39 in-depth interviews with families, link workers and healthcare professionals. Together these data were analysed within a SROI to establish the costs and social value generated. Results Of 48 families supported by the service, 25 were recruited to the evaluation (26 children, aged 10 m-15y; 4 siblings; 36 parents). Baseline quality of life and wellbeing indices averaged below population norms. Link workers were highly effective at supporting families (only 6/151 goals unmet). Unmet need decreased by 6 months (Support Star, p < 0.001). Families reported having felt overwhelmed when trying to adjust to new ways of life post diagnosis/discharge before link worker intervention, with little support to navigate non-medical needs. Parents, link workers and health care professionals found link worker support invaluable for making community services accessible. Families then felt more connected to their communities, and less isolated, with increased belief in their self-efficacy. Families and healthcare professionals felt that the duration of support, and eligibility criteria, should be extended. Inputs to deliver the service for 1 year (49 families) were estimated at £74,736: outcomes for the 18 families studied were estimated at a value of £205,861. Conclusion Hospital in-reach social prescribing is feasible, acceptable, and addresses a range of otherwise unmet needs of children with neurodisability and their families, showing a positive SROI. Other vulnerable patient groups could also benefit from this approach. Trial registration ISRCTN23306751 (2.8.22).https://doi.org/10.1186/s12913-025-12329-0Social prescribingNeurodisabilityChildHospital settingCommunity settingLink worker
spellingShingle Laura Gordon
Megan Hastry
Angela Bate
Katie Gordon
Emily Greaves
Simoni Dimitriadou
Tim Rapley
Anna Purna Basu
Hospital in-reach family-centred social prescribing pilot for children with neurodisability: mixed methods evaluation with social return on investment analysis
BMC Health Services Research
Social prescribing
Neurodisability
Child
Hospital setting
Community setting
Link worker
title Hospital in-reach family-centred social prescribing pilot for children with neurodisability: mixed methods evaluation with social return on investment analysis
title_full Hospital in-reach family-centred social prescribing pilot for children with neurodisability: mixed methods evaluation with social return on investment analysis
title_fullStr Hospital in-reach family-centred social prescribing pilot for children with neurodisability: mixed methods evaluation with social return on investment analysis
title_full_unstemmed Hospital in-reach family-centred social prescribing pilot for children with neurodisability: mixed methods evaluation with social return on investment analysis
title_short Hospital in-reach family-centred social prescribing pilot for children with neurodisability: mixed methods evaluation with social return on investment analysis
title_sort hospital in reach family centred social prescribing pilot for children with neurodisability mixed methods evaluation with social return on investment analysis
topic Social prescribing
Neurodisability
Child
Hospital setting
Community setting
Link worker
url https://doi.org/10.1186/s12913-025-12329-0
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