In this pilot project, Age UK Oxfordshire (AUKO) and the Old Fire Station, Oxford (OFS) used the Storytelling Evaluation Methodology (Storytelling) to learn about social prescribing work undertaken by AUKO.
The project aimed to help understand the impact of social prescribing through listening to the experiences of those at its heart – clients, link workers, project partners, whilst also experimenting with Storytelling as a way of evaluating social prescribing more broadly.
Key takeaways
Understanding AUKO’s social prescribing
• The role of the social prescriber is holistic, adaptable, and preventative. It requires sensitivity, skill, a deep understanding of local provision, and an effective network of professional support.
• The experience of social prescribing clients is often rooted in experiences of bereavement and loss, but with courage and well-designed support people can rediscover hope, purpose, and wellbeing.
• The context in which social prescribing happens is highly complex, involving relationships between clients, a diverse range of local providers, and healthcare services. Social prescribing work sometimes lacks the resources to be effective.
• The phrase ‘social prescribing’ is not well understood, but is now in common usage. It fails to describe well how heavily the practice relies on building and sustaining supportive relationships.
Reflections on using Storytelling to evaluate social prescribing
* Provides rich qualitative data that helps us understand the relationship-based, context-specific, and preventative nature of social prescribing.
* Centres experiences of those at the heart of the work, and is a meaningful and collaborative process.
* Can be time consuming and resource intensive.
* Tends to focus on learning from positive changes. When used in isolation, there is a risk that this makes it harder to hear less positive stories.
What is Social Prescribing?
Social prescribing is a service provided by GP surgeries and other organisations that ‘connects people to activities, groups, and services in their community to meet the practical, social, and emotional needs that affect their wellbeing’.
This could include attending a community choir to address loneliness, joining an exercise class to maintain physical fitness, or accessing support with benefit payments or household management.
What is the Storytelling Evaluation Methodology?
The Storytelling Evaluation Methodology (Storytelling) is an evaluation methodology developed by OFS and inspired by Most Significant Change (MSC).
It involves collecting stories from participants about their involvement in a project, and then bringing people together to discuss these stories and what can be learned from them. You can read more about the methodology and how it works in practice here.
KEY THEMES EMERGING FROM THE STORIES
1. Being alongside
“I think that sums up how a lot of people feel. They feel that they are on their own, that their life has ended, that there is nothing. If we weren't able to get alongside them, listen to them, and hear how we can help, there would be people like that who would just exist until they didn't.” (Story 7)
2. Proactiveness & prevention
“People think of social prescribers as what you would do in an emergency. And that is not true. It's to stop you getting to that emergency. You know, you need the right sort of help at the right sort of time.” (Story 4)
3. When to push & when not to
“If you're going to kind of play around the edges, you're not going to get to the whole problem. I think people appreciate being asked, because sometimes it's really hard, isn't it, to actually come out with what's bothering you. So I'm more direct. It's just become a habit now. And the more you do it, you know, the more you realise it is okay, you can do this. You’re not gonna break anybody by asking questions, as long as you do it sensitively.” (Story 3)
4. Bereavement & loss
“When you get married, you become one. I've known my wife since the age of 16. When that person goes, you lose half of yourself. And then you’ve got to rebuild it again. In fact, I'm beginning to think you never get over bereavement. I don't know. I felt I had to sort myself out. I get very lonely. I used to weep, still do. First thing I thought, I’ll sell the house. It’s too big. Then I changed my mind. I couldn't sleep.” (Story 1)
5. Rediscovering hope & purpose
“Silver Pride forced me to do something else and it broke the spiral. If I hadn't met guys from Mind and Silver Pride, I think I would have stooped low. I would have been classed as an agoraphobic, and I would have been hospitalised.” (Story 2)
6. The courage to try something new
“In the end, I did what the doctor told me. She gave me sleeping pills and Jackie Roberts [Link worker] came round. Jackie sat exactly where you’re sitting. And thanks to her, and my faith, I managed to rebuild my confidence. I couldn't talk to you six-months ago, no chance.” (Story 1)
7. Embedding social prescribing
“The good thing about us is that it doesn’t matter what referral you get or what the case is, because you may be a social prescriber but you've got an army of people behind you. You can get the information you need, and you can get the assistance you need to help that person. Some surgeries employ social prescribers who work on their own, are not part of an organisation, and they do struggle sometimes. We’ve had calls from people who are struggling to find things to link in to. “(Story 7)
8. Barriers to engagement
“An awful lot of people don't think help is available to them. They don't put themselves in that category. We didn't. If anybody had asked me at that point, I would have said I was sure we didn't qualify. You know, we're just older, this is what happens when you get older. That's quite sad, isn't it? There must be so many people who never get further than ‘I don't qualify.’” (Story 4)
9. Health & social care capacity
“At any one time, I usually have between 25 and 40 open cases. Since 2019, I’ve worked with around 350 people, and we've got a few repeat ones.” (Story 3)
conclusion
Social prescribing can be an effective way to support people with practical, social, and emotional needs.
The stories collected here recount radical improvements in clients’ abilities to maintain their own wellbeing, brought about through the skilled delivery of social prescribing services. The stories and the discussion highlight the holistic, adaptable, and preventative role of the social prescriber.
Storytelling can capture the detail and diversity of social prescribing work and complement other evaluation tools, adding depth and richness to the evidence base. There are obstacles to implementing Storytelling at scale and in the context of a resource-poor healthcare sector.
However, to understand why social prescribing is effective it is important to make use of longer-form, person centred evaluation tools.
In the coming month we will continue to deepen our understanding of using Storytelling to understand the impact of social prescribing. This will include hosting a roundtable with clinicians and commissioners on social prescribing and meaningful measurement, and commencing a research project with the Centre for Evidence Based Medicine, University of Oxford.
If you are interested in hearing more about this work, or have experiences of ideas you’d like to share, we’d love to hear from you.
