Spring Northamptonshire Interim Evaluation Report

Spring is a Northamptonshire based community-driven support network that seeks to help people lead a full and meaningful life whilst managing long term health concerns. It offers an effective and locally sourced social prescribing model of health care that seeks to increase the wellbeing and mental health of at risk-communities in Northamptonshire that is supported by the NHS and Public Health Northamptonshire. This social prescribing initiative links people to local services that seek to improve their mental health, rediscover pleasures, and take control of their own life through an intensive six-to-twelve-month programme. The goal is to encourage close connections to the community that encourage habit and the building of sustainable social networks so that when the service user exits the programme, they feel an innate part of the community.

The use of social prescribing has grown as health services tackle growing budgetary and economic challenges, and attempt to manage the increase in chronic conditions, such as diabetes and mental illness (NHS Digital, 2018; NHS England, 2017). Chronic conditions are exacerbated by loneliness, which can cause individuals to see the world as threatening, triggering psychological stress responses (Cacioppo and Cacioppo, 2018). As a remedy to this, people experiencing loneliness more frequently attend primary care institutions as a safe source of social connection, which can place strain on services (Cruwys et al., 2018). The impact of loneliness; however, goes further than the financial implications for health care services. Currently, the number of over 50’s expected to experience loneliness is set to reach two million by 2025/26 in the UK, a 49% increase in 10 years, with those individuals 26% more at risk of death (Campaign to End Loneliness, n.d.).

The impact of loneliness and the strain it puts on both the individual and the healthcare system has led to alternative non-medical solutions, including social prescribing. Social prescribing enhances the individuals’ social connections, improving the well-being of patients suffering long-term conditions (Kimberlee, 2015). The goal of social prescribing is to encourage self-management of illness and reduce the need for primary care. As the name suggests, social prescribing has a significant social element, with service users signposted toward ‘Link Workers’ who encourage engagement in community groups and programmes, to help develop a sense of belonging (Rempel et al., 2017). Research has shown that these interventions are cost-effective and enhance health and wellbeing; however, there are questions as to why social connectedness enhances health outcomes, and how best to target and understand its effects on those participating to maximise the benefits of future programmes (Bickerdike et al., 2017; Polley et al.,2022).

As social prescribing is more commonly adopted by healthcare practitioners, approaches to evaluation have continued to evolve. There have; however, been difficulties in the adoption of a standard model, in part due to the diverse application of approach, activities promoted, intensity of the intervention and model of action (Elliot et al., 2022). Such variety in social prescribing has led to inconsistent research designs or non-generalisable evidence on how and why these interventions are successful (Bickerdale et al., 2016).

Examining prior evaluations, Elliot et al., (2022) and Bickerdale et al., (2016) have highlighted themes of acceptable and high-quality research: Stakeholder involvement; mixed-methods; a multilevel and coordinated research framework; and the use of evaluation to inform. These aspects are included within the research design, with attention paid to the characteristic that sets Spring apart from other social prescribing initiatives including its intensity. This report represents the Interim analysis point for the project, with the full findings, recommendations and impact calculations to be made in the full report.